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EP4499146A1 - Polythérapie pour le traitement de cancers exprimant trop -2 - Google Patents

Polythérapie pour le traitement de cancers exprimant trop -2

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Publication number
EP4499146A1
EP4499146A1 EP23717004.8A EP23717004A EP4499146A1 EP 4499146 A1 EP4499146 A1 EP 4499146A1 EP 23717004 A EP23717004 A EP 23717004A EP 4499146 A1 EP4499146 A1 EP 4499146A1
Authority
EP
European Patent Office
Prior art keywords
administered
magrolimab
cancer
ctla4
dose
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP23717004.8A
Other languages
German (de)
English (en)
Inventor
Mark P. CHAO
William J. GROSSMAN
Inderjit D. LAL
Fatema A. LEGRAND
Nathalie Scholler
Jamie G. BATES
Hikmat H. ASSI
Chih-Chien Chou
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Gilead Sciences Inc
Original Assignee
Gilead Sciences Inc
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Filing date
Publication date
Application filed by Gilead Sciences Inc filed Critical Gilead Sciences Inc
Publication of EP4499146A1 publication Critical patent/EP4499146A1/fr
Withdrawn legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/337—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having four-membered rings, e.g. taxol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
    • A61K39/39533—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals
    • A61K39/3955—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals against proteinaceous materials, e.g. enzymes, hormones, lymphokines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
    • A61K39/39533—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals
    • A61K39/39558—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals against tumor tissues, cells, antigens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/68—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment
    • A61K47/6801—Drug-antibody or immunoglobulin conjugates defined by the pharmacologically or therapeutically active agent
    • A61K47/6803—Drugs conjugated to an antibody or immunoglobulin, e.g. cisplatin-antibody conjugates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/68—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment
    • A61K47/6801—Drug-antibody or immunoglobulin conjugates defined by the pharmacologically or therapeutically active agent
    • A61K47/6803—Drugs conjugated to an antibody or immunoglobulin, e.g. cisplatin-antibody conjugates
    • A61K47/68037—Drugs conjugated to an antibody or immunoglobulin, e.g. cisplatin-antibody conjugates the drug being a camptothecin [CPT] or derivatives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/68—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment
    • A61K47/6835—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment the modifying agent being an antibody or an immunoglobulin bearing at least one antigen-binding site
    • A61K47/6851—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment the modifying agent being an antibody or an immunoglobulin bearing at least one antigen-binding site the antibody targeting a determinant of a tumour cell
    • A—HUMAN NECESSITIES
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    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/68—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment
    • A61K47/6835—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment the modifying agent being an antibody or an immunoglobulin bearing at least one antigen-binding site
    • A61K47/6851—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment the modifying agent being an antibody or an immunoglobulin bearing at least one antigen-binding site the antibody targeting a determinant of a tumour cell
    • A61K47/6857—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment the modifying agent being an antibody or an immunoglobulin bearing at least one antigen-binding site the antibody targeting a determinant of a tumour cell the tumour determinant being from lung cancer cell
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A61P35/04—Antineoplastic agents specific for metastasis
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/30—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants from tumour cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/545—Medicinal preparations containing antigens or antibodies characterised by the dose, timing or administration schedule
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00

Definitions

  • TNBC Triple negative breast cancer
  • mTNBC metastatic TNBC
  • Taxane-based chemotherapeutic regimens are considered standard of care in first line (IL) therapy for patients with mTNBC (Cardoso, et al., Hepatology AASLD Abstracts (2012) 56(4):384A-5A), with single-agent taxanes as the recommended chemotherapy regimen across international guidelines.
  • IL first line
  • OS median overall survival
  • TNBC trophoblast cell-surface antigen 2
  • Stituzumab govitecan is a Trop-2 targeted antibody with camptothecin- derived agent SN-38, a topoisomerase I inhibitor, as its payload that binds to Trop-2 for targeted delivery of SN-38 directly to the tumor cell while minimizing systemic exposure of SN 38 to decrease host toxicity.
  • the study also showed an improved overall survival of 12.1 months in the sacituzumab govitecan arm versus 6.7 months in the chemotherapy arm (Bardia, et al., N Engl J Med (2021) 384 (16): 1529-41).
  • the results of this study led to the approval of sacituzumab govitecan in patients with unresectable locally advanced or mTNBC who have received 2 or more prior systemic therapies, at least 1 of them for metastatic disease.
  • CD47 Cluster of differentiation 47
  • CD47 expression is a well-characterized mechanism by which cancer cells, including cancer stem cells, overcome phagocytosis due to intrinsic expression of prophagocytic “eat me” signals (Jaiswal, et al., Cell (2009) 138(2):271-85; Majeti, et al., Cell (2009) 138(2):286-99).
  • the progression from normal cell to cancer cell involves changes in genes and gene expression that trigger programmed cell death and programmed cell removal (Chao, et al., Nat Rev Cancer. (2012) 12(l):58-67).
  • CD47 the dominant antiphagocytic signal
  • AME human acute myeloid leukemia
  • CD47-blocking monoclonal antibodies inhibit human xenograft tumor growth and metastasis by enabling the phagocytosis and elimination of cancer cells from various hematologic malignancies and solid tumors (Chao, et al., Cancer Res (2011) 71(4): 1374-84; Chao, et al., Cell (2010) 142:699-713; Chao, et al., Blood (2011) 118 (18):4890-901; Edris, et al., Proc Natl Acad Sci U SA (2012) 109( 17):6656-61 ;
  • an anti-CD47 antibody can induce an anticancer T-cell response through cross-presentation of tumor antigens by macrophage and antigen-presenting cells after tumor cell phagocytosis (Liu, et al., Nat Med (2015) 21(10):1209-15, Tseng, et al., Proc Natl Acad Sci U S A (2013) 110(27): 11103-8).
  • Magrolimab is a humanized anti-CD47 mAb that blocks the interaction of CD47 with its receptor and enables phagocytosis of human cancer cells (Liu, et al., PLoS One. (2015) 10 (9):e0137345).
  • the activity of magrolimab is primarily dependent on blocking CD47 binding to SIRPa and not on the recruitment of fragment crystallizable (Fc) dependent effector functions, although the presence of the immunoglobulin G4 (IgG4) Fc domain is required for its full activity.
  • magrolimab was engineered with a human IgG4 isotype that is relatively inefficient at recruiting Fc-dependent effector functions that might enhance toxic effects on normal CD47-expressing cells (Liu, et al., PLoS One. (2015), supra).
  • Nonclinical studies using xenograft cancer models provide compelling evidence that magrolimab triggers phagocytosis and elimination of cancer cells from human solid tumors and hematologic malignancies. Based on this mechanism of action (MOA) and its potent nonclinical activity, magrolimab is being developed as a therapeutic candidate for solid tumors and hematologic malignancies.
  • Sacituzumab govitecan sold under the brand name TRODELVY® is an antibodydrug conjugate composed of 3 compounds: a humanized monoclonal antibody, a topoisomerase- I inhibitor, and linker protein. It binds to Trop-2) expressing cells, forming an internalized complex that releases SN-38 intracellularly. SN-38 binds to topoisomerase LDNA complexes, causing DNA damage and apoptosis. Sacituzumab govitecan is approved in several countries, including the US, Canada, EU, and Australia, for the treatment of unresectable locally advanced or mTNBC.
  • TNBC TNBC-based on the ASCENT protocol, a Phase 3, multicenter study with 468 patients with relap sed/refractory TNBC (Bardia, et al., N Engl J Med (2021) 384 (16): 1529-41). Patients were randomly assigned to receive sacituzumab govitecan (235 patients) or chemotherapy (233 patients). The median age was 54 years, all patients were previously treated with taxanes and had no brain metastases. Sacituzumab govitecan was dosed at 10 mg/kg on days 1 and 8 every 21 days until progression or unacceptable toxicity.
  • Sacituzumab govitecan demonstrated a longer median PFS (5.6 vs 1.7 months), and longer median overall survival (12.1 vs 6.7 months) than the chemotherapy arm.
  • the percentage of patients with an objective response was 35% with sacituzumab govitecan and 5% with chemotherapy.
  • a method of treating, mitigating, reducing, preventing or delaying the growth, proliferation recurrence or metastasis of, a Trop-2-positive or Tropeexpressing cancer in a mammalian subject in need thereof comprising co-administering to the subject an effective amount of: (a) an anti-Trop-2 antibody-drug conjugate (ADC); and (b) an agent that inhibits binding between CD47 and SIRPa.
  • ADC anti-Trop-2 antibody-drug conjugate
  • the Tropepositive or Trop-2-expressing cancer is a solid epithelial cancer.
  • the cancer is selected from breast cancer (e.g., triple negative breast cancer), colorectal cancer, lung cancer, stomach cancer, urinary tract cancer, urothelial cancer, bladder cancer, renal cancer, pancreatic cancer, ovarian cancer, uterine cancer, esophageal cancer and prostatic cancer.
  • the cancer is (i) unresectable, locally advanced or (ii) metastatic.
  • the cancer is selected from metastatic non-small-cell lung cancer, metastatic small-cell lung cancer, metastatic urothelial cancer and metastatic pancreatic cancer.
  • the cancer is a breast cancer selected from triple-negative breast cancer, HR+/HER2- breast cancer, and HER2+ breast cancer.
  • the treatment results in a reduction in overall tumor burden of at least 15%, at least 20%, at least 30%, or at least 40%, as determined using linear dimensional methods (e.g. RECIST vl.l).
  • the method comprises reducing in size or eliminating the metastases.
  • the cancer does not recur or the tumor burden does not regrow after cessation of treatment.
  • the cancer has cell surface expression of CD47.
  • the agent that inhibits binding between CD47 and SIRPa comprises an antibody that binds to CD47.
  • the antibody that binds to CD47 is selected from magrolimab, lemzoparlimab, letaplimab, ligufalimab, AO-176, simridarlimab (IBI-322), gentulizumab, ZL-1201, IMC-002, SRF-231, CC-90002 (a.k.a., INBRX-103), NI-1701 (a.k.a., TG-1801) and STI-6643.
  • the agent that inhibits binding between CD47 and SIRPa comprises an antibody that binds to SIRPa.
  • the antibody that binds to SIRPa is selected from GS-0189 (a.k.a., FSI-189), CC-95251, BI-765063 and APX- 700.
  • the agent that inhibits binding between CD47 and SIRPa comprises a SIRPa-Fc fusion protein.
  • the SIRPa-Fc fusion protein is selected from ALX-148 (evorpacept), timdarpacept, TTI-621, TTI-622, JMT601 (CPO107) and SL-172154.
  • the anti-Trop-2 ADC comprises a topoisomerase I inhibitor.
  • the topoisomerase I inhibitor is selected from irinotecan, topetecan and SN-38.
  • the anti-Trop-2 ADC has a structural formula of mAb-CL2A-SN-38), with a structure represented by:
  • the anti- Trop-2 ADC comprises sacituzumab (hRS7; disclosed, e.g., in W02003074566, Figures 3 and 4).
  • the anti-Trop-2 ADC is selected from sacituzumab govitecan, datopotamab deruxtecan (DS-1062), ESG-401, SKB-264, DAC-02 and BAT-8003.
  • the anti-Trop-2 ADC comprises sacituzumab govitecan.
  • the agent that inhibits binding between CD47 and SIRPa and the anti-Trop-2 ADC are administered concurrently or sequentially.
  • the magrolimab is administered at a subtherapeutic dose.
  • the sacituzumab govitecan is administered at a subtherapeutic dose.
  • the magrolimab and the sacituzumab govitecan are co-administered at subtherapeutic doses.
  • the method further comprises administering a taxane.
  • the taxane is selected from paclitaxel, nab-paclitaxel (ABRAXANE®), docetaxel and cabazitaxel.
  • the method further comprises administering one or more therapeutic antibodies.
  • the method further comprises co-administering one or more blockers or inhibitors of one or more T-cell stimulatory immune checkpoint proteins or receptors.
  • the one or more immune checkpoint inhibitors comprises a proteinaceous (e.g., antibody) inhibitor of PD-L1 (CD274), PD-1 (PDCD1) or CTLA4.
  • the one or more immune checkpoint proteins or receptors are selected from: CD274 (CD274, PDL1, PD-L1) and programmed cell death 1 (PDCD1, PD1, PD-1).
  • the proteinaceous (e.g., antibody) inhibitor of CTLA4 is selected from ipilimumab, tremelimumab, BMS-986218, AGEN1181, AGEN1884 (zalifrelimab), BMS-986249, MK-1308, REGN-4659, ADU-1604, CS-1002, BCD-145, APL-509, JS-007, BA-3071, ONC-392, AGEN-2041, JHL- 1155, KN-044, CG-0161, ATOR-1144, PBI-5D3H5, FPT-155 (CTLA4/PD-L1/CD28), PF- 06936308 (PD-1/CTLA4), MGD-019 (PD-1/CTLA4), KN-046 (PD-1/CTLA4), MEDI-5752 (CTLA4/PD-1), XmAb-20717 (PD-1/CTLA4) and AK-104 (CTLA4/PD-1).
  • ipilimumab tre
  • the proteinaceous (e.g., antibody) inhibitor of programmed cell death 1 is selected from zimberelimab (AB 122, GLS-010, WBP-3055), pembrolizumab (KEYTRUDA®, MK-3475, SCH900475), nivolumab (OPDIVO®, BMS-936558, MDX-1106), cemiplimab (LIBTAYO®; cemiplimab-rwlc, REGN- 2810), pidilizumab (CT-011), AMG-404, MEDI0680 (AMP-514), spartalizumab (PDR001), tislelizumab (BGB-A317), toripalimab (JS-001), genolimzumab (CBT-501, APL-501, GB 226), SHR-1201, camrelizuma
  • zimberelimab AB 122, GLS-010, WBP-3055
  • the proteinaceous (e.g., antibody) inhibitor of CD274 molecule is selected from atezolizumab (TECENTRIQ®), avelumab (BAVENCIO®; MSB0010718C), envafolimab (ASC22), durvalumab (IMFINZI®; MEDI-4736), BMS-936559 (MDX1105), cosibelimab (CK-301), lodapolimab (LY 3300054), garivulimab (BGB A333), envafolimab (KN035), opucolimab (HLX 20), manelimab (BCD 135), CX-072, CBT-502 (TQB2450), MSB-2311, SHR-1316, sugemalimab (CS-1001; WBP3155), A167 (KL-A167, H
  • the method comprises co-administering an agonist of fms related receptor tyrosine kinase 3 (FLT3).
  • the agonist of FLT3 is selected from GS-3583 and CDX-301.
  • the agent that inhibits binding between CD47 and SIRPa and the anti-Trop-2 ADC are administered in a combined synergistic amount.
  • administration of the agent that inhibits binding between CD47 and SIRPa and the anti-Trop-2 ADC provides a synergistic effect.
  • the synergistic effect is increased cancer cell death and/or decreased cancer cell growth when comparing the effect of the combination versus either the agent that inhibits binding between CD47 and SIRPa or the anti-Trop-2 ADC alone. In some embodiments, the synergistic effect is increased phagocytosis of cancer cells by macrophages when comparing the effect of the combination versus either the agent that inhibits binding between CD47 and SIRPa or the anti- Trop-2 ADC alone. In some embodiments, the synergistic effect is increased or enhanced tumor burden reduction when comparing the effect of the combination versus either the agent that inhibits binding between CD47 and SIRPa or the anti-Trop-2 ADC alone. In some embodiments, the subject is human.
  • the cancer has progressed following at least one prior anti-cancer therapy.
  • the subject is treatment naive.
  • a method of treating, mitigating, reducing, preventing or delaying the growth, proliferation, recurrence or metastasis of, a cancer in a subject comprising administering to the subject an effective amount of: (a) magrolimab; and (b) sacituzumab govitecan.
  • the cancer is a solid epithelial cancer.
  • the cancer is selected from breast cancer (e.g., triple negative breast cancer), colorectal cancer, lung cancer, stomach cancer, urinary tract cancer, urothelial cancer, bladder cancer, renal cancer, pancreatic cancer, ovarian cancer, uterine cancer, esophageal cancer and prostatic cancer.
  • the cancer is (i) unresectable, locally advanced or (ii) metastatic.
  • the cancer is selected from metastatic non- small-cell lung cancer, metastatic small-cell lung cancer, metastatic urothelial cancer and metastatic pancreatic cancer.
  • the cancer is a breast cancer selected from triple-negative breast cancer, HR+/HER2- breast cancer, and HER2+ breast cancer.
  • the treatment results in a reduction in overall tumor burden of at least 15%, at least 20%, at least 30%, or at least 40%, as determined using linear dimensional methods (e.g. RECIST vl.l).
  • the method comprises reducing in size or eliminating the metastases.
  • the cancer does not recur or the tumor burden does not regrow after cessation of treatment.
  • the cancer has cell surface expression of CD47.
  • the magrolimab and the sacituzumab govitecan are administered concurrently or sequentially. In some embodiments, the magrolimab is administered at a subtherapeutic dose.
  • the sacituzumab govitecan is administered at a subtherapeutic dose. In some embodiments, the magrolimab and the sacituzumab govitecan are co-administered at subtherapeutic doses. In some embodiments, the method further comprises administering a taxane. In some embodiments, the taxane is selected from paclitaxel, nab- paclitaxel (ABRAXANE®), docetaxel and cabazitaxel. In some embodiments, the method further comprises co-administering one or more therapeutic antibodies. In some embodiments, the method further comprises co-administering one or more blockers or inhibitors of one or more T-cell stimulatory immune checkpoint proteins or receptors.
  • the one or more immune checkpoint inhibitors comprises a proteinaceous (e.g., antibody) inhibitor of PD-L1 (CD274), PD-1 (PDCD1) or CTLA4.
  • the one or more immune checkpoint proteins or receptors are selected from: CD274 (CD274, PDL1, PD-L1) and programmed cell death 1 (PDCD1, PD1, PD-1).
  • the proteinaceous (e.g., antibody) inhibitor of CTLA4 is selected from ipilimumab, tremelimumab, BMS-986218, AGEN1181, AGEN1884 (zalifrelimab), BMS-986249, MK-1308, REGN-4659, ADU-1604, CS-
  • the proteinaceous (e.g., antibody) inhibitor of programmed cell death 1 is selected from zimberelimab (AB 122, GLS-010, WB P-3055), pembrolizumab (KEYTRUDA®, MK-3475, SCH900475), nivolumab (OPDIVO®, B MS- 936558, MDX-1106), cemiplimab (LIBTAYO®; cemiplimab-rwlc, REGN-2810), pidilizumab (CT-011), AMG-404, MEDI0680 (AMP-514), spartalizumab (PDR001), tislelizumab (BGB- A317), toripalimab (JS-001), genolimzumab (CBT-501, APL-501, GB 226), SHR-1201, camreli
  • PDCD1 programmed cell death 1
  • Zmberelimab AB 122, GLS-01
  • the proteinaceous (e.g., antibody) inhibitor of CD274 molecule is selected from atezolizumab (TECENTRIQ®), avelumab (BAVENCIO®; MSB0010718C), envafolimab (ASC22), durvalumab (IMFINZI®; MEDI-4736), BMS-936559 (MDX1105), cosibelimab (CK-301), lodapolimab (LY 3300054), garivulimab (BGB A333), envafolimab (KN035), opucolimab (HLX 20), manelimab (BCD 135), CX-072, CBT-502 (TQB2450), MSB-2311, SHR-1316, sugemalimab (CS-1001; WBP3155), A167 (KL-A167, H
  • the method comprises co-administering an agonist of fms related receptor tyrosine kinase 3 (FLT3).
  • the agonist of FLT3 is selected from GS-3583 and CDX-301.
  • the magrolimab and the sacituzumab govitecan are administered in a combined synergistic amount.
  • administration of the magrolimab and the sacituzumab govitecan provides a synergistic effect.
  • the synergistic effect is increased cancer cell death and/or decreased cancer cell growth when comparing the effect of the combination versus either the magrolimab or the sacituzumab govitecan alone.
  • the synergistic effect is increased phagocytosis of cancer cells by macrophages when comparing the effect of the combination versus either the magrolimab or the sacituzumab govitecan alone. In some embodiments, the synergistic effect is increased or enhanced tumor burden reduction when comparing the effect of the combination versus either the magrolimab or the sacituzumab govitecan alone. In some embodiments, the magrolimab is first administered at a priming dose of less than 10 mg/kg and then administered at one or more therapeutic doses of at least 15 mg/kg, e.g., at least 30 mg/kg, 45 mg/kg, 60 mg/kg.
  • the magrolimab is first administered at a priming dose of less than 5 mg/kg and then administered at one or more therapeutic doses of at least 30 mg/kg, e.g., 45 mg/kg, 60 mg/kg. In some embodiments, the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 30 mg/kg, followed by administration of one or more therapeutic doses of 60 mg/kg. In some embodiments, the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 20 mg/kg, followed by administration of one or more therapeutic doses of 45 mg/kg.
  • the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 15 mg/kg, followed by administration of one or more therapeutic doses of 30 mg/kg. In some embodiments, the magrolimab is administered intravenously, subcutaneously or intratumorally.
  • the magrolimab is administered intravenously, e.g., through an in-line filter, e.g., through an in-line filter having a pore size of 5 pm, e.g., through an in-line filter having a pore size of 1.2 pm, e.g., through an in-line filter having a pore size of 0.45 pm, e.g., through an in-line filter having a pore size of 0.22 pm.
  • the sacituzumab govitecan is administered at one or more doses in the range of 3 mg/kg to 18 mg/kg, e.g., 8 mg/kg to 10 mg/kg.
  • the sacituzumab govitecan is administered at one or more doses of 10 mg/kg. In some embodiments, the sacituzumab govitecan is administered intravenously, subcutaneously or intratumorally. In some embodiments, the subject is a human. In some embodiments, the cancer has progressed following at least one prior anti-cancer therapy. In some embodiments, the subject is treatment naive.
  • a method of treating, mitigating, reducing, preventing or delaying the growth, proliferation, recurrence or metastasis of, a triple-negative breast cancer (TNBC) in a subject comprising administering to the subject an effective amount of: (a) magrolimab; and (b) sacituzumab govitecan.
  • the TNBC is (i) unresectable, locally advanced or (ii) metastatic.
  • the treatment results in a reduction in overall tumor burden of at least 15%, at least 20%, at least 30%, or at least 40%, as determined using linear dimensional methods (e.g. RECIST vl.l).
  • the method comprises reducing in size or eliminating the metastases.
  • the cancer does not recur or the tumor burden does not regrow after cessation of treatment.
  • the TNBC has cell surface expression of CD47.
  • the magrolimab and the sacituzumab govitecan are administered concurrently or sequentially.
  • the magrolimab is administered at a subtherapeutic dose.
  • the sacituzumab govitecan is administered at a subtherapeutic dose.
  • the magrolimab and the sacituzumab govitecan are co-administered at subtherapeutic doses.
  • the method further comprises administering a taxane.
  • the taxane is selected from paclitaxel, nab-paclitaxel (ABRAXANE®), docetaxel and cabazitaxel.
  • the method further comprises administering one or more therapeutic antibodies.
  • the method further comprises co-administering one or more blockers or inhibitors of one or more T-cell stimulatory immune checkpoint proteins or receptors.
  • the one or more immune checkpoint inhibitors comprises a proteinaceous (e.g., antibody) inhibitor of PD-L1 (CD274), PD-1 (PDCD1) or CTLA4.
  • the one or more immune checkpoint proteins or receptors are selected from: CD274 (CD274, PDL1, PD-L1) and programmed cell death 1 (PDCD1, PD1, PD-1).
  • the proteinaceous (e.g., antibody) inhibitor of CTLA4 is selected from ipilimumab, tremelimumab, BMS-986218, AGEN1181, AGEN1884 (zalifrelimab), BMS-986249, MK-1308, REGN-4659, ADU-1604, CS- 1002, BCD-145, APL-509, JS-007, BA-3071, ONC-392, AGEN-2041, JHL-1155, KN-044, CG- 0161, ATOR-1144, PBI-5D3H5, FPT-155 (CTLA4/PD-L1/CD28), PF-06936308 (PD- 1/CTLA4), MGD-019 (PD-1/CTLA4), KN-046 (PD-1/
  • the proteinaceous (e.g., antibody) inhibitor of programmed cell death 1 is selected from zimberelimab (AB 122, GLS-010, WB P-3055), pembrolizumab (KEYTRUDA®, MK-3475, SCH900475), nivolumab (OPDIVO®, B MS- 936558, MDX-1106), cemiplimab (LIBTAYO®; cemiplimab-rwlc, REGN-2810), pidilizumab (CT-011), AMG-404, MEDI0680 (AMP-514), spartalizumab (PDR001), tislelizumab (BGB- A317), toripalimab (JS-OO1), genolimzumab (CBT-501, APL-501, GB 226), SHR-1201, cam
  • the proteinaceous (e.g., antibody) inhibitor of CD274 molecule is selected from atezolizumab (TECENTRIQ®), avelumab (BAVENCIO®; MSB0010718C), envafolimab (ASC22), durvalumab (IMFINZI®; MEDI-4736), BMS-936559 (MDX1105), cosibelimab (CK-301), lodapolimab (LY 3300054), garivulimab (BGB A333), envafolimab (KN035), opucolimab (HLX 20), manelimab (BCD 135), CX-072, CBT-502 (TQB2450), MSB-2311, SHR-1316, sugemalimab (CS-1001; WBP3155), A167 (KL-A167, H
  • the method comprises co-administering an agonist of fms related receptor tyrosine kinase 3 (FLT3).
  • the agonist of FLT3 is selected from GS-3583 and CDX-301.
  • the magrolimab and the sacituzumab govitecan are administered in a combined synergistic amount.
  • administration of the magrolimab and the sacituzumab govitecan provides a synergistic effect.
  • the synergistic effect is increased cancer cell death and/or decreased cancer cell growth when comparing the effect of the combination versus either the magrolimab or the sacituzumab govitecan alone.
  • the synergistic effect is increased phagocytosis of cancer cells by macrophages when comparing the effect of the combination versus either the magrolimab or the sacituzumab govitecan alone. In some embodiments, the synergistic effect is increased or enhanced tumor burden reduction when comparing the effect of the combination versus either the magrolimab or the sacituzumab govitecan alone. In some embodiments, the magrolimab is first administered at a priming dose of less than 10 mg/kg and then administered at one or more therapeutic doses of at least 15 mg/kg, e.g., at least 30 mg/kg, 45 mg/kg, 60 mg/kg.
  • the magrolimab is first administered at a priming dose of less than 5 mg/kg and then administered at one or more therapeutic doses of at least 30 mg/kg, e.g., 45 mg/kg, 60 mg/kg. In some embodiments, the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 30 mg/kg, followed by administration of one or more therapeutic doses of 60 mg/kg. In some embodiments, the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 20 mg/kg, followed by administration of one or more therapeutic doses of 45 mg/kg.
  • the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 15 mg/kg, followed by administration of one or more therapeutic doses of 30 mg/kg. In some embodiments, the magrolimab is administered intravenously, subcutaneously or intratumorally.
  • the magrolimab is administered intravenously, e.g., through an in-line filter, e.g., through an in-line filter having a pore size of 5 pm, e.g., through an in-line filter having a pore size of 1.2 pm, e.g., through an in-line filter having a pore size of 0.45 pm, e.g., through an in-line filter having a pore size of 0.22 pm.
  • the sacituzumab govitecan is administered at one or more doses in the range of 3 mg/kg to 18 mg/kg, e.g., 8 mg/kg to 10 mg/kg.
  • the sacituzumab govitecan is administered at one or more doses of 10 mg/kg.
  • the sacituzumab govitecan is administered intravenously, subcutaneously or intratumorally.
  • the magrolimab and the sacituzumab govitecan are administered for first, second and third 21-day cycles, wherein: (a) for the first 21-day cycle, magrolimab is administered at a dose of 1 mg/kg on day 1 and at a dose of 30 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 or 2 and 8 (z.e., on days 1 and 8 or on days 2 and 8); (b) for the second 21-day cycle, magrolimab is administered at a dose of 30 mg/kg on days 1, 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8;
  • the magrolimab and the sacituzumab govitecan are administered for first, second and third 21-day cycles, wherein: (a) for the first 21-day cycle, magrolimab is administered at a dose of 1 mg/kg on day 1 and at a dose of 20 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 or 2 and 8 (z.e., on days 1 and 8 or on days 2 and 8); (b) for the second 21-day cycle, magrolimab is administered at a dose of 20 mg/kg on days 1, 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8; and (c) for the third 21-day cycle, magrolimab is administered at a dose of 45 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8.
  • the magrolimab and the sacituzumab govitecan are administered for first, second and third 21-day cycles, wherein: (a) for the first 21-day cycle, magrolimab is administered at a dose of 1 mg/kg on day 1 and at a dose of 15 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 or 2 and 8 (z.e., on days 1 and 8 or on days 2 and 8); (b) for the second 21-day cycle, magrolimab is administered at a dose of 15 mg/kg on days 1, 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8; and (c) for the third 21-day cycle, magrolimab is administered at a dose of 30 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8.
  • NSCLC non- small cell lung cancer
  • the NSCLC is (i) unresectable, locally advanced or (ii) metastatic.
  • the cancer is unresectable, locally advanced and the subject is treatment naive.
  • the treatment results in a reduction in overall tumor burden of at least 15%, at least 20%, at least 30%, or at least 40%, as determined using linear dimensional methods (e.g. RECIST vl.l).
  • the method comprises reducing in size or eliminating the metastases.
  • the cancer does not recur or the tumor burden does not regrow after cessation of treatment.
  • the NSCLC has cell surface expression of CD47.
  • the magrolimab and the sacituzumab govitecan are administered concurrently or sequentially. In some embodiments, the magrolimab is administered at a subtherapeutic dose.
  • the sacituzumab govitecan is administered at a subtherapeutic dose. In some embodiments, the magrolimab and the sacituzumab govitecan are co-administered at subtherapeutic doses. In some embodiments, the method further comprises administering a taxane. In some embodiments, the taxane is selected from paclitaxel, nab- paclitaxel (ABRAXANE®), docetaxel and cabazitaxel. In some embodiments, the method further comprises administering one or more therapeutic antibodies. In some embodiments, the method further comprises co-administering one or more blockers or inhibitors of one or more T- cell stimulatory immune checkpoint proteins or receptors.
  • the one or more immune checkpoint inhibitors comprises a proteinaceous (e.g., antibody) inhibitor of PD- L1 (CD274), PD-1 (PDCD1) or CTLA4.
  • the one or more immune checkpoint proteins or receptors are selected from: CD274 (CD274, PDL1, PD-L1) and programmed cell death 1 (PDCD1, PD1, PD-1).
  • the proteinaceous (e.g., antibody) inhibitor of CTLA4 is selected from ipilimumab, tremelimumab, BMS-986218, AGEN1181, AGEN1884 (zalifrelimab), BMS-986249, MK-1308, REGN-4659, ADU-1604, CS- 1002, BCD-145, APL-509, JS-007, BA-3071, ONC-392, AGEN-2041, JHL-1155, KN-044, CG- 0161, ATOR-1144, PBI-5D3H5, FPT-155 (CTLA4/PD-L1/CD28), PF-06936308 (PD- 1/CTLA4), MGD-019 (PD-1/CTEA4), KN-046 (PD-1/CTEA4), MEDI-5752 (CTEA4/PD-1), XmAb-20717 (PD-1/CTEA4) and AK-104 (CTEA4/PD-1).
  • the proteinaceous (e.g., antibody) inhibitor of programmed cell death 1 is selected from zimberelimab (AB 122, GES-010, WB P-3055), pembrolizumab (KEYTRUDA®, MK-3475, SCH900475), nivolumab (OPDIVO®, B MS- 936558, MDX-1106), cemiplimab (LIBTAYO®; cemiplimab-rwlc, REGN-2810), pidilizumab (CT-011), AMG-404, MEDI0680 (AMP-514), spartalizumab (PDR001), tislelizumab (BGB- A317), toripalimab (JS-001), genolimzumab (CBT-501, APL-501, GB 226), SHR-1201, camreli
  • PDCD1 programmed cell death 1
  • Zmberelimab AB 122, GES-01
  • the proteinaceous (e.g., antibody) inhibitor of CD274 molecule is selected from atezolizumab (TECENTRIQ®), avelumab (BAVENCIO®; MSB0010718C), envafolimab (ASC22), durvalumab (IMFINZI®; MEDI-4736), BMS-936559 (MDX1105), cosibelimab (CK-301), lodapolimab (LY 3300054), garivulimab (BGB A333), envafolimab (KN035), opucolimab (HLX 20), manelimab (BCD 135), CX-072, CBT-502 (TQB2450), MSB-2311, SHR-1316, sugemalimab (CS-1001; WBP3155), A167 (KL-A167, H
  • the method further comprises co-administering an agonist of fms related receptor tyrosine kinase 3 (FET3).
  • FET3 fms related receptor tyrosine kinase 3
  • the agonist of FET3 is selected from GS-3583 and CDX-301.
  • the magrolimab and the sacituzumab govitecan are administered in a combined synergistic amount.
  • administration of the magrolimab and the sacituzumab govitecan provides a synergistic effect.
  • the synergistic effect is increased cancer cell death and/or decreased cancer cell growth when comparing the effect of the combination versus either the magrolimab or the sacituzumab govitecan alone.
  • the synergistic effect is increased phagocytosis of cancer cells by macrophages when comparing the effect of the combination versus either the magrolimab or the sacituzumab govitecan alone. In some embodiments, the synergistic effect is increased or enhanced tumor burden reduction when comparing the effect of the combination versus either the magrolimab or the sacituzumab govitecan alone. In some embodiments, the magrolimab is first administered at a priming dose of less than 10 mg/kg and then administered at one or more therapeutic doses of at least 15 mg/kg, e.g., at least 30 mg/kg, 45 mg/kg, 60 mg/kg.
  • the magrolimab is first administered at a priming dose of less than 5 mg/kg and then administered at one or more therapeutic doses of at least 30 mg/kg, e.g., 45 mg/kg, 60 mg/kg. In some embodiments, the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 30 mg/kg, followed by administration of one or more therapeutic doses of 60 mg/kg. In some embodiments, the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 20 mg/kg, followed by administration of one or more therapeutic doses of 45 mg/kg.
  • the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 15 mg/kg, followed by administration of one or more therapeutic doses of 30 mg/kg. In some embodiments, the magrolimab is administered intravenously, subcutaneously or intratumorally.
  • the magrolimab is administered intravenously, e.g., through an in-line filter, e.g., through an in-line filter having a pore size of 5 pm, e.g., through an in-line filter having a pore size of 1.2 pm, e.g., through an in-line filter having a pore size of 0.45 pm, e.g., through an in-line filter having a pore size of 0.22 pm.
  • the sacituzumab govitecan is administered at one or more doses in the range of 3 mg/kg to 18 mg/kg, e.g., 8 mg/kg to 10 mg/kg.
  • the sacituzumab govitecan is administered at one or more doses of 10 mg/kg.
  • the sacituzumab govitecan is administered intravenously, subcutaneously or intratumorally.
  • the magrolimab and the sacituzumab govitecan are administered for first, second and third 21-day cycles, wherein: (a) for the first 21-day cycle, magrolimab is administered at a dose of 1 mg/kg on day 1 and at a dose of 30 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 or 2 and 8 (z.e., on days 1 and 8 or on days 2 and 8); (b) for the second 21-day cycle, magrolimab is administered at a dose of 30 mg/kg on days 1, 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8;
  • the magrolimab and the sacituzumab govitecan are administered for first, second and third 21-day cycles, wherein: (a) for the first 21-day cycle, magrolimab is administered at a dose of 1 mg/kg on day 1 and at a dose of 20 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 or 2 and 8 (z.e., on days 1 and 8 or on days 2 and 8); (b) for the second 21-day cycle, magrolimab is administered at a dose of 20 mg/kg on days 1, 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8; and (c) for the third 21-day cycle, magrolimab is administered at a dose of 45 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8.
  • the magrolimab and the sacituzumab govitecan are administered for first, second and third 21-day cycles, wherein: (a) for the first 21-day cycle, magrolimab is administered at a dose of 1 mg/kg on day 1 and at a dose of 15 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 or 2 and 8 (z.e., on days 1 and 8 or on days 2 and 8); (b) for the second 21-day cycle, magrolimab is administered at a dose of 15 mg/kg on days 1, 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8; and (c) for the third 21-day cycle, magrolimab is administered at a dose of 30 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8.
  • kits comprising one or more unitary doses of: (a) an agent that inhibits binding between CD47 and SIRPa; and (b) an anti-Trop-2 antibody-drug conjugate (ADC).
  • the agent that inhibits binding between CD47 and SIRPa and anti-Trop-2 ADC are in separate containers.
  • the separate containers are selected from vials, ampoules and preloaded syringes.
  • the agent that inhibits binding between CD47 and SIRPa comprises an antibody that binds to CD47.
  • antibody that binds to CD47 is selected from magrolimab, lemzoparlimab, letaplimab, ligufalimab, AO- 176, simridarlimab (IB 1-322), gentulizumab, ZL- 1201, IMC-002, SRF-231, CC-90002 (a.k.a., INBRX-103), NI-1701 (a.k.a., TG-1801) and STI- 6643.
  • the agent that inhibits binding between CD47 and SIRPa comprises an antibody that binds to SIRPa.
  • the antibody that binds to SIRPa is selected from GS-0189 (a.k.a., FSI-189), CC-95251, BI-765063 and APX-700.
  • the agent that inhibits binding between CD47 and SIRPa comprises a SIRPa-Fc fusion protein.
  • the SIRPa-Fc fusion protein is selected from ALX-148, TTI-621, TTI-622, JMT601 (CPO107) and SL-172154.
  • the anti-Trop-2 ADC comprises a topoisomerase I inhibitor.
  • the topoisomerase I inhibitor is selected from irinotecan, topetecan and SN-38.
  • the anti-Trop-2 ADC has a structural formula of mAb-CL2A-SN-38, with a structure represented by:
  • the anti-Trop-2 ADC comprises sacituzumab (hRS7; described, e.g., in W02003074566, Figures 3 and 4).
  • the anti-Trop-2 ADC is selected from sacituzumab govitecan, datopotamab deruxtecan (DS-1062), ESG-401, SKB-264, DAC-02 and BAT-8003.
  • the anti-Trop-2 ADC comprises sacituzumab govitecan.
  • the kit further comprises one or more unitary doses of a taxane.
  • the taxane is selected from paclitaxel, nab-paclitaxel (ABRAXANE®), docetaxel and cabazitaxel.
  • the kit further comprises one or more therapeutic antibodies.
  • the kit further comprises one or more blockers or inhibitors of one or more T-cell inhibitory immune checkpoint proteins or receptors.
  • the kit further comprises a proteinaceous (e.g., antibody) inhibitor of PD-L1 (CD274), PD-1 (PDCD1) or CTLA4.
  • the kit further comprises a proteinaceous (e.g., antibody) inhibitor of PD-L1 (CD274) or PD-1 (PDCD1).
  • the proteinaceous (e.g., antibody) inhibitor of CTLA4 is selected from ipilimumab, tremelimumab, BMS-986218, AGEN1181, AGEN1884 (zalifrelimab), BMS-986249, MK-1308, REGN-4659, ADU-1604, CS-
  • the proteinaceous (e.g., antibody) inhibitor of programmed cell death 1 is selected from zimberelimab (AB 122, GLS-010, WB P-3055), pembrolizumab (KEYTRUDA®, MK-3475, SCH900475), nivolumab (OPDIVO®, B MS- 936558, MDX-1106), cemiplimab (LIBTAYO®; cemiplimab-rwlc, REGN-2810), pidilizumab (CT-011), AMG-404, MEDI0680 (AMP-514), spartalizumab (PDR001), tislelizumab (BGB- A317), toripalimab (JS-001), genolimzumab (CBT-501, APL-501, GB 226), SHR-1201, camreli
  • PDCD1 programmed cell death 1
  • Zmberelimab AB 122, GLS-01
  • the proteinaceous (e.g., antibody) inhibitor of CD274 molecule is selected from atezolizumab (TECENTRIQ®), avelumab (BAVENCIO®; MSB0010718C), envafolimab (ASC22), durvalumab (IMFINZI®; MEDI-4736), BMS-936559 (MDX1105), cosibelimab (CK-301), lodapolimab (LY 3300054), garivulimab (BGB A333), envafolimab (KN035), opucolimab (HLX 20), manelimab (BCD 135), CX-072, CBT-502 (TQB2450), MSB-2311, SHR-1316, sugemalimab (CS-1001; WBP3155), A167 (KL-A167, H
  • FIG. 1 illustrates a study schematic, as described herein.
  • mTNBC metastatic triple-negative breast cancer
  • N number of patients
  • R ratio
  • RP2D recommended Phase 2 dose.
  • Figure 2 illustrates the efficacy of magrolimab, sacituzumab govitecan (TRODELVY®), or their combination to inhibit tumor growth in an orthotopic MDA-MB-468 xenograft model.
  • hIgG4 and hlgGl-ADC Iso were used to control for magrolimab and sacituzumab govitecan, respectively.
  • Groups and dosing scheme are described in Table 4. Dosing was stopped for all arms after three weeks while tumor growth continued to be monitored.
  • FIGs 3A-3F illustrate tumor growth data for individual mice, plotted for each dose group.
  • Isotype control Fig. 3A
  • ADC-Iso control Fig. 3B
  • sacituzumab govitecan alone Fig. 3C
  • Treatment with magrolimab alone or magrolimab plus ADC-Iso control Figs. 3D-3E, respectively
  • Figs. 3D-3E were regressing tumors around day 5, but tumors regrew upon agent withdrawal.
  • Administering the combination of magrolimab and sacituzumab govitecan elicited tumor regression and mice remained tumor free for over 2 months post-withdrawal of active agents (Fig. 3F).
  • Figure 4 illustrates percent change in body weight for all groups over the dosing period.
  • a Trop-2 expressing cancer in a subject by administering an effective amount of: (a) an agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab); and (b) an anti-Trop-2 antibody drug conjugate (ADC) (e.g., sacituzumab govitecan) to the subject.
  • ADC anti-Trop-2 antibody drug conjugate
  • an agent that inhibits binding between a CD47 and SIRPa e.g., magrolimab
  • an anti-Trop-2 ADC e.g., sacituzumab govitecan
  • phagocytosis of Trop-2 expressing cancer cells results in synergistic (z.e., more than additive) phagocytosis of Trop-2 expressing cancer cells and reduction in tumor growth.
  • Illustrative Trop-2 expressing cancers include most solid epithelial cancers, including without limitation breast cancer (e.g., triple negative breast cancer), colorectal cancer, lung cancer, stomach cancer, urinary tract cancer, bladder cancer, renal cancer, pancreatic cancer, ovarian cancer, uterine cancer, esophageal cancer and prostatic cancer.
  • Sacituzumab govitecan was developed to treat cancers by binding to Trop-2 for targeted delivery of SN-38 directly to the tumor cell while minimizing systemic exposure of SN-38 to decrease host toxicity.
  • the Trop-2 antigen is highly expressed on most solid epithelial cancers, including TNBC.
  • Sacituzumab govitecan causes DNA damage and apoptosis, which can serve as the second pro-apoptotic signal in tumor cells exposed to magrolimab.
  • magrolimab to sacituzumab govitecan can have an added antitumor effect due to the expression of CD47 and Trop-2 on TNBC tumor cells without a significant increase in toxicity due to nonoverlapping safety profiles.
  • magrolimab dose proposed in this study originates from safety, efficacy, and PK/pharmacodynamics (PD) data and modeling and simulation analyses based on data obtained from all ongoing and completed clinical studies with magrolimab in patients with solid tumors, non-Hodgkin’s lymphoma (NHL), and acute myeloid leukemia (AML) / myelodysplastic syndrome (MDS).
  • PD pharmacodynamics
  • magrolimab in the first-in-human study of magrolimab in patients with solid tumors and lymphomas, after an initial priming dose of 1 mg/kg on the first day, magrolimab was tested as a monotherapy at weekly doses of up to 45 mg/kg.
  • a priming dose leads to an initial, transient, and mild anemia that generally normalizes back to baseline over several weeks, even in the presence of repeated therapeutic doses of magrolimab (Advani, et al., N Engl J Med (2016) 379 (18): 1711-21; Liu, et al., PLoS One. (2015) 10(9):e0137345; Sikic, et al., J Clin Oncol (2019) 37(12):946-53). Based on PK-PD modeling, a maintenance dose of 30 mg/kg every 2 weeks is expected to provide more than 90% occupancy of the CD47 receptor in peripheral blood and tumor tissues and thus is expected to provide maximal efficacy while maintaining adequate safety.
  • magrolimab every 3 weeks In solid tumors where the combination therapy is given according to 3-week cycles, dosing of magrolimab every 3 weeks optimizes patient and caregiver convenience.
  • Magrolimab 60 mg/kg every 3 weeks is predicted to provide a similar trough concentration and receptor occupancy (RO) as the 30 mg/kg every 2 weeks dose, the dose being used in Phase 3 studies in AML and MDS.
  • Updated pharmacokinetic (PK) modeling from Study 5F9005 NCT03248479) showed that the magrolimab dose of 45 mg/kg every 3 weeks was suboptimal compared to 30 mg/kg every 2 weeks and 60 mg/kg every 3 weeks dosing in maintaining trough concentration. Maintaining adequate trough concentration may be necessary for optimal efficacy considering that some patients may experience dose delays due to toxicity.
  • PK / pharmacodynamic (PD) modelling also indicates that at these extended interval dosing regimens, the RO will be maintained at maximal levels (> 90%) in peripheral blood and tumor tissues.
  • the proposed dosing regimen of magrolimab in this study is expected to have an acceptable safety profile based on the entirety of safety data in multiple oncology populations, both as a monotherapy and in combination with other tumor-targeted antibodies and chemotherapeutics.
  • Trop-2 The trophoblast cell-surface antigen 2 (Trop-2) antigen (NCBI Gene ID: 4070; a.k.a., tumor associated calcium signal transducer 2 (TACSTD2)) is highly expressed on most solid epithelial cancers, including TNBC.
  • Sacituzumab govitecan is a Trop-2 targeted antibody with camptothecin-derived agent SN-38, a topoisomerase I inhibitor, as its payload that binds to Trop-2 for targeted delivery of SN-38 directly to the tumor cell while minimizing systemic exposure of SN 38 to decrease host toxicity.
  • the study also showed an improved overall survival of 12.1 months in the sacituzumab govitecan arm versus 6.7 months in the chemotherapy arm (Bardia, et al., N Engl J Med (2021) 384 (16): 1529-41).
  • the results of this study led to the approval of sacituzumab govitecan in patients with unresectable locally advanced or mTNBC who have received 2 or more prior systemic therapies, at least 1 of them for metastatic disease.
  • the agent that inhibits binding between CD47 and SIRPa is an antibody or antigen-binding fragment thereof that binds to CD47 (a.k.a., IAP, MER6, OA3; NCBI Gene ID: 961; UniProt Q08722).
  • an antibody that binds to CD47 has an Fc having effector function.
  • an antibody that binds to CD47 is an IgG4 or an IgGl.
  • anti-CD47 antibodies of use include without limitation magrolimab, lemzoparlimab, letaplimab, ligufalimab (AK117), AO-176, simridarlimab (IBI-322), gentulizumab, ZE-1201, IMC-002, SRF-231, CC-90002 (a.k.a., INBRX-103), NI-1701 (a.k.a., TG-1801), STI-6643 (Vx-1004), CNTO-7108, RCT-1938, RRx- 001, DSP-107, VT-1021 and SGN-CD47M.
  • the antibody targeting CD47 is a bi-specific antibody.
  • bi-specific antibodies targeting CD47 include without limitation simridarlimab (IBI- 322) (CD47/PD-L1), IMM-0306 (CD47/CD20), TJ-L1C4 (CD47/PD-L1), HX-009 (CD47/PD- 1), PMC-122 (CD47/PD-L1), PT-217, (CD47/DLL3), IMM-26011 (CD47/FLT3), IMM-0207 (CD47/VEGF), IMM-2902 (CD47/HER2), BH29xx (CD47/PD-L1), IMM-03 (CD47/CD20), IMM-2502 (CD47/PD-L1), HMBD-004B (CD47/BCMA), HMBD-004A (CD47/CD33).
  • simridarlimab IBI- 322
  • IMM-0306 CD47/CD20
  • TJ-L1C4 CD47/
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to Kabat), respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to IM GT), respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to Chothia), respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to Honegger), respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting CD47 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting CD47 comprises a VH and a VL comprising the amino acid sequences set forth, respectively, or comprise amino acid sequences that are at least 80%, at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identical to the amino acid sequences set forth, respectively, in:
  • Sequence identity can be determined according to the BLAST algorithm (blast.ncbi.nlm.nih.gov/Blast.cgi), using default settings.
  • Additional anti-CD47 antibodies of use in the present methods include those described in WO199727873, WO199940940, W02002092784, W02005044857, W02009046541, W02010070047, WO2011143624, W02012170250, WO2013109752, WO2013119714, WO2014087248, WO2015191861, WO2016022971, W02016023040, W02016024021, WO2016081423, W02016109415, WO2016141328, WO2016188449, WO2017027422, WO2017049251, WO2017053423, WO2017121771, WO2017194634, WO2017196793, WO2017215585, WO2018075857, W02018075960, W02018089508, WO2018095428, WO2018137705, WO2018233575, W02019027903, WO2019034895, W02019042119,
  • the agent that inhibits binding between CD47 and SIRPa CD47 is an antibody or antigen-binding fragment thereof that binds to signal regulatory protein alpha (SIRPa) (NCBI Gene ID: 140885; UniProt P78324).
  • SIRPa signal regulatory protein alpha
  • Illustrative antibodies that bind to SIRPa include without limitation GS-0189 (FSI-189), ES-004, BI765063, ADU1805, and CC-95251.
  • an antibody can comprise one or more CDRs of 1H9. In some embodiments, an antibody can comprise all CDRs of 1H9. In some embodiments, an antibody can comprise one or more variable sequences of 1H9. In some embodiments, an antibody can comprise each variable sequence of 1H9. In some embodiments, an antibody can comprise the heavy chain of 1H9. In some embodiments, an antibody can comprise the light chain of 1H9. In some embodiments, an antibody can comprise the heavy chain and the light chain of 1H9. In some embodiments, an antibody is 1H9.
  • an antibody can comprise one or more CDRs of 3C2. In some embodiments, an antibody can comprise all CDRs of 3C2. In some embodiments, an antibody can comprise one or more variable sequences of 3C2. In some embodiments, an antibody can comprise each variable sequence of 3C2. In some embodiments, an antibody can comprise the heavy chain of 3C2. In some embodiments, an antibody can comprise the light chain of 3C2. In some embodiments, an antibody can comprise the heavy chain and the light chain of 3C2. In some embodiments, an antibody is 3C2. [0043] In some embodiments, an antibody can comprise one or more CDRs of 9B 11. In some embodiments, an antibody can comprise all CDRs of 9B11.
  • an antibody can comprise one or more variable sequences of 9B 11. In some embodiments, an antibody can comprise each variable sequence of 9B 11. In some embodiments, an antibody can comprise the heavy chain of 9B 11. In some embodiments, an antibody can comprise the light chain of 9B 11. In some embodiments, an antibody can comprise the heavy chain and the light chain of 9B 11. In some embodiments, an antibody is 9B 11.
  • an antibody can comprise one or more CDRs of 7E11. In some embodiments, an antibody can comprise all CDRs of 7E11. In some embodiments, an antibody can comprise one or more variable sequences of 7E11. In some embodiments, an antibody can comprise each variable sequence of 7E11. In some embodiments, an antibody can comprise the heavy chain of 7E11. In some embodiments, an antibody can comprise the light chain of 7E11. In some embodiments, an antibody can comprise the heavy chain and the light chain of 7E11. In some embodiments, an antibody is 7E11.
  • Additional anti-SIRPa antibodies of use in the present methods include those described in W0200140307, W02002092784, W02007133811, W02009046541, W02010083253, WO2011076781, WO2013056352, W02015138600, WO2016179399, W02016205042, WO2017178653, W02018026600, WO2018057669, W02018107058, W02018190719, WO2018210793, WO2019023347, W02019042470, WO2019175218, WO2019183266, W02020013170, W02020068752 and W02020088580.
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to Kabat), respectively:
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to IM GT), respectively: • SEQ ID NOs: 125, 126, 127, 128, 129 and 98;
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to Chothia), respectively:
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to Honegger), respectively:
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting SIRPa comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting SIRPa comprises a VH and a VL comprising the amino acid sequences set forth, respectively, or comprise amino acid sequences that are at least 80%, at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identical to the amino acid sequences set forth, respectively, in:
  • Sequence identity can be determined according to the BLAST algorithm (blast.ncbi.nlm.nih.gov/Blast.cgi), using default settings.
  • the agent that inhibits binding between CD47 and SIRPa CD47 is a SIRPa-Fc fusion protein or a “high affinity SIRPa reagent”, which includes SIRPa-derived polypeptides and analogs thereof.
  • High affinity SIRPa reagents are described in international application WO2013109752A1, which is hereby specifically incorporated by reference. High affinity SIRPa reagents are variants of the native SIRPa protein.
  • a high affinity SIRPa reagent is soluble, where the polypeptide lacks the SIRPa transmembrane domain and comprises at least one amino acid change relative to the wild-type SIRPa sequence, and wherein the amino acid change increases the affinity of the SIRPa polypeptide binding to CD47, for example by decreasing the off-rate by at least 10-fold, at least 20-fold, at least 50-fold, at least 100-fold, at least 500-fold, or more.
  • a high affinity SIRPa reagent comprises the portion of SIRPa that is sufficient to bind CD47 at a recognizable affinity, e.g., high affinity, which normally lies between the signal sequence and the transmembrane domain, or a fragment thereof that retains the binding activity.
  • the high affinity SIRPa reagent will usually comprise at least the dl domain of SIRPa with modified amino acid residues to increase affinity.
  • a SIRPa variant is a fusion protein, e.g., fused in frame with a second polypeptide.
  • the second polypeptide is capable of increasing the size of the fusion protein, e.g., so that the fusion protein will not be cleared from the circulation rapidly.
  • the second polypeptide is part or whole of an immunoglobulin Fc region.
  • the Fc region aids in phagocytosis by providing an “eat me” signal, which enhances the block of the “don't eat me” signal provided by the high affinity SIRPa reagent.
  • the second polypeptide is any suitable polypeptide that is substantially similar to Fc, e.g., providing increased size, multimerization domains, and/or additional binding or interaction with 1g molecules.
  • the amino acid changes that provide for increased affinity are localized in the dl domain, and thus high affinity SIRPa reagents comprise a dl domain of human SIRPa, with at least one amino acid change relative to the wild-type sequence within the dl domain.
  • Such a high affinity SIRPa reagent optionally comprises additional amino acid sequences, for example antibody Fc sequences; portions of the wild-type human SIRPa protein other than the dl domain, including without limitation residues 150 to 374 of the native protein or fragments thereof, usually fragments contiguous with the dl domain; and the like.
  • High affinity SIRPa reagents may be monomeric or multimeric, i.e., dimer, trimer, tetramer, etc.
  • Illustrative SIRPa-Fc fusion proteins of use include ALX-148 (a.k.a..
  • evorpacept described in WO2013109752
  • timdarpacept TTI-621 or TTI-622 (described in WO2014094122)
  • SIRPa-F8 JY002-M2Gl(N297A)
  • JMT601 CPO107
  • SS002M91 SIRPalpha-lgG4-Fc-Fc
  • hCD172a(SIRPa)-Fc-LIGHT hCD172a(SIRPa)-Fc-LIGHT.
  • the methods described herein involve co-administration of an agent that inhibits binding between CD47 and SIRPa and an anti-Trop-2 antibody-drug conjugate (ADC).
  • Trop-2 is also known as tumor associated calcium signal transducer 2 (TACSTD2; NCBI Gene ID: 4070; Uniprot P09758; having alternative acronyms EGP1; GP50; M1S1; EGP-1; TROP2;
  • the drug in the anti-Trop-2 ADC comprises a topoisomerase I inhibitor.
  • the topoisomerase I inhibitor is selected from irinotecan, topetecan and SN-38.
  • drug conjugate of the anti-Trop-2 ADC has a structural formula of mAb-CL2A-SN-38), with a structure represented by:
  • the anti-Trop-2 ADC comprises sacituzumab (hRS7; disclosed, e.g., in W02003074566, Figures 3 and 4).
  • hRS7 disclosed, e.g., in W02003074566, Figures 3 and 4.
  • anti-Trop-2 ADC of use in the present methods include without limitation sacituzumab govitecan, datopotamab deruxtecan (DS-1062), ESG-401, SKB-264, D AC-02 and BAT-8003.
  • the antibody targeting Trop-2 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to Kabat), respectively:
  • the antibody targeting Trop-2 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to IM GT), respectively:
  • the antibody targeting Trop-2 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to Chothia), respectively:
  • the antibody targeting Trop-2 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences (according to Honegger), respectively:
  • the antibody targeting Trop-2 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting Trop-2 comprises a VH-CDR1, a VH-CDR2, a VH-CDR3, a VL-CDR1, a VL-CDR2 and a VL-CDR3 comprising the following amino acid sequences, respectively:
  • the antibody targeting Trop-2 comprises a VH and a VL comprising the amino acid sequences set forth, respectively, or comprise amino acid sequences that are at least 80%, at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identical to the amino acid sequences set forth, respectively, in:
  • Sequence identity can be determined according to the BLAST algorithm (blast.ncbi.nlm.nih.gov/Blast.cgi), using default settings.
  • Additional agents such as small molecules, antibodies, adoptive cellular therapies and chimeric antigen receptor T cells (CAR-T), checkpoint inhibitors, and vaccines, that are appropriate for treating hematological malignancies can be administered in combination with the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab); and the anti- Trop-2 ADC (e.g., sacituzumab govitecan), as described herein.
  • additional immunotherapeutic agents for hematological malignancies are described in Dong, et al, J Life Sci (Westlake Village). 2019 June; 1(1): 46-52; and Cuesta-Mateos, et al, Front. Immunol. 8:1936. doi: 10.3389/fimmu.2017.01936, each of which are hereby incorporated by reference in their entireties for all purposes.
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab); and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, is further combined with one or more additional therapeutic agents, e.g., an inhibitory immune checkpoint blocker or inhibitor, a stimulatory immune checkpoint stimulator, agonist or activator, a chemotherapeutic agent, an anti-cancer agent, a radiotherapeutic agent, an anti- neoplastic agent, an anti-proliferation agent, an anti- angiogenic agent, an anti-inflammatory agent, an immunotherapeutic agent, a therapeutic antigen-binding molecule (mono- and multispecific antibodies and fragments thereof in any format (e.g., including without limitation DARTs®, Duobodies®, BiTEs®, BiKEs, TriKEs, XmAbs®, TandAbs®, scFvs, Fabs, Fabs, Fabs, Fab
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab); and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, is further combined with one or more additional therapeutic agents including, without limitation, an inhibitor, agonist, antagonist, ligand, modulator, stimulator, blocker, activator or suppressor of a target (e.g., polypeptide or polynucleotide) including without limitation: Abelson murine leukemia viral oncogene homolog 1 gene (ABL, such as ABL1), Acetyl-CoA carboxylase (such as ACC 1/2), activated CDC kinase (ACK, such as ACK1), Adenosine deaminase, adenosine receptor (such as A2BR, A2aR, A3aR), Adenylate cyclase, ADP ribosyl cyclase- 1,
  • ABL Abelson mur
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • one or more additional therapeutic agents that may be categorized by their mechanism of action into, for example, the following groups: anti-metabolites/anti-cancer agents, such as pyrimidine analogs floxuridine, capecitabine, cytarabine, CPX-351 (liposomal cytarabine, daunorubicin), and TAS-118; Alpha 1 adrenoceptor/ Alpha 2 adrenoceptor antagonists, such as phenoxybenzamine hydrochloride (injectable, pheochromocytoma); Androgen receptor antagonists, such as nilutamide; anti-cadherin antibodies, such as HKT-288; anti-leucine-rich repeat containing 15 (LRRC15) antibodies
  • anti-metabolites/anti-cancer agents such as
  • anti-HLA-DR antibodies such as IMMU-114; anti-IL-3 antibodies, such as JNJ-56022473; anti-TNF receptor superfamily member 18 (TNFRSF18, GITR; NCBI Gene ID: 8784) antibodies, such as MK-4166, MEDI1873, FPA-154, INCAGN-1876, TRX-518, BMS-986156, MK-1248, GWN-323; and those described, e.g., in Inti. Patent Publ. Nos.
  • anti-EphA3 antibodies such as KB-004
  • anti-CD37 antibodies such as otlertuzumab (TRU-016)
  • anti-FGFR-3 antibodies such as LY3076226, B-701
  • anti-FGFR-2 antibodies such as GAL-F2
  • anti-C5 antibodies such as ALXN-1210
  • anti- EpCAM antibodies such as VB4-845
  • anti-CEA antibodies such as RG-7813
  • anti- Carcinoembryonic-antigen-related-cell-adhesion-molecule-6 (CEACAM6, CD66C) antibodies such as BAY-1834942, NEO-201 (CEACAM 5/6)
  • anti-GD2 antibodies such as APN-301
  • anti- interleukin- 17 (IL- 17) antibodies such as CJM-112
  • anti-interleukin- 1 beta antibodies such as canakinuma
  • Glucocorticoid receptor antagonists such as relacorilant (CORT-125134); Second mitochondria-derived activator of caspases (SMAC) protein inhibitors, such as BL 891065; Lactoferrin modulators, such as LTX-315; KIT proto-oncogene, receptor tyrosine kinase (KIT) inhibitors, such as PLX-9486; platelet derived growth factor receptor alpha (PDGFRA)/KIT proto-oncogene, receptor tyrosine kinase (KIT) mutant- specific antagonists/inhibitors such as BLU-285, DCC-2618; Exportin 1 inhibitors, such as eltanexor; CHST15 gene inhibitors, such as STNM-01; Somatostatin receptor antagonist, such as OPS-201; CEBPA gene stimulators, such as MTL-501; DKK3 gene modulators, such as MTG-201; Chemokine (CXCR1/CXCR2)
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab); and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, is further combined with one or more additional therapeutic agents comprising an inhibitor or antagonist of: myeloid cell leukemia sequence 1 (MCL1) apoptosis regulator (NCBI Gene ID: 4170); mitogen-activated protein kinase 1 (MAP4K1) (also called Hematopoietic Progenitor Kinase 1 (HPK1), NCBI Gene ID: 11184); diacylglycerol kinase alpha (DGKA, DAGK, DAGK1 or DGK-alpha; NCBI Gene ID: 1606); 5'-nucleotidase ecto (NT5E or CD73; NCBI Gene ID: 4907); ectonucleoside triphosphate diphosphohydrolase 1 (ENTPD
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • FLT3 agonists include, but are not limited to, CDX-301 and GS-3583.
  • GS-3583 is described, e.g., in WO 2020/263830, hereby incorporated herein by reference in its entirety for all purposes.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD19 agent or antibody examples include without limitation: blinatumomab, tafasitamab, XmAb5574 (Xencor), AFM-11, inebilizumab, loncastuximab, MEDI 551 (Cellective Therapeutics); and MDX-1342 (Medarex).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD20 agent or antibody is further combined with an anti-CD20 agent or antibody.
  • anti-CD20 agents or antibodies that can be co-administered include without limitation: IGN-002, PF- 05280586; Rituximab (Rituxan/B iogen plec), Ofatumumab (Arzerra/Genmab), Obinutuzumab (Gazyva/Roche Glycart Biotech), Alemtuzumab, Veltuzumab, Veltuzumab, Ocrelizumab (Ocrevus/B iogen pi; Genentech), Ocaratuzumab and Ublituximab, and LFB-R603 (LFB Biotech.; rEVO Biologies).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD22 agent or antibody examples include without limitation: Epratuzumab, AMG-412, IMMU-103 (Immunomedics).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD30 agent or antibody examples include without limitation: Brentuximab vedotin (Seattle Genetics).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD33 agent or antibody examples include without limitation: gemtuzumab, lintuzumab, vadastuximab, CIK-CAR.CD33; CD33CART, AMG-330 (CD33/CD3), AMG-673 (CD33/CD3), and GEM-333 (CD3/CD33), and IMGN-779.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD37 agent or antibody examples include without limitation: BI836826 (Boehringer Ingelheim), Otlertuzumab, and TRU-016 (Trubion Pharmaceuticals).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD38 agent or antibody is further combined with an anti-CD38 agent or antibody.
  • anti-CD38 agents or antibodies that can be co-administered include without limitation: CD38, such as T- 007, UCART-38; Darzalex (Genmab), Daratumumab, JNJ-54767414 (Darzalex/Genmab), Isatuximab, SAR650984 (ImmunoGen), MOR202, MOR03087 (MorphoSys), TAK-079; and anti-CD38-attenukine, such as TAK573.
  • CD38 such as T- 007, UCART-38
  • Darzalex Genemab
  • Daratumumab Daratumumab
  • JNJ-54767414 Darzalex/Genmab
  • Isatuximab Isatuximab
  • SAR650984 ImmunoGen
  • MOR202 MOR03087
  • TAK-079 anti-CD38-attenukine
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD52 agent or antibody examples include without limitation: anti-CD52 antibodies, such as Alemtuzumab (Campath/University of Cambridge).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD98 (4F2, FRP-1) agent or antibody examples include without limitation: IGN523 (Igenica).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • BST-1 anti-CD157
  • anti-CD157 agents or antibodies that can be co-administered include without limitation: OBT357, MENU 12 (Menarini; Oxford BioTherapeutics).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti- DKK-1 agent or antibody examples include without limitation: BHQ88O (MorphoSys; Novartis), and DKN-01, LY-2812176 (Eli Lilly).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-GRP78 agent or antibody examples include without limitation: PAT-SM6 (OncoMab GmbH).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-NOTCHl agent or antibody examples include without limitation: Brontictuzumab, OMP-52M51 (OncoMed Pharmaceuticals).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-RORl agent or antibody examples include without limitation: Mapatumumab, TRM1, and HGS-1012 (Cambridge Antibody Technology).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-SLAMF7 (CS1, CD319) agent or antibody examples include without limitation: Elotuzumab, HuLuc63, BMS-901608 (Empliciti/PDL BioPharma), Mogamulizumab (KW- 0761).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-TNFRSFlOA DR4; APO2; CD261; TRAILR1;
  • TRAILR-1) agent or antibody examples include without limitation: Mapatumumab, TRM1, and HGS-1012 (Cambridge Antibody Technology).
  • the agent that inhibits binding between CD47 and CD47 is selected from CD47 and CD47
  • SIRPa e.g., magrolimab
  • anti-Trop-2 ADC e.g., sacituzumab govitecan
  • TFRC anti-Transferrin Receptor
  • anti-Transferrin Receptor agents or antibodies that can be co-administered include without limitation: E2.3/A27.15 (University of Arizona).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-EPHA3 agent or antibody examples include without limitation: Ifabotuzumab, KB004 (Ludwig Institute for Cancer Research).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CCR4 agent or antibody examples include without limitation: Mogamulizumab, KW-0761 (Poteligeo/Kyowa Hakko Kirin Co.).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CXCR4 agent or antibody examples include without limitation: Ulocuplumab, BMS-936564, MDX-1338 (Medarex), and PF-06747143 (Pfizer).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-BAFF agent or antibody examples include without limitation: Tabalumab, LY2127399 (Eli Lilly).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • BAFF-R anti-BAFF Receptor
  • anti-BAFF-R agents or antibodies that can be co-administered examples include without limitation: VAY736 (MorphoSys; Novartis).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-RANKL agent or antibody examples include without limitation: Denosumab, AMG- 162 (Prolia; Ranmark; Xgeva/Amgen).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-IL-6 agent or antibody examples include without limitation: Siltuximab, CNTO-328 (Sylvant/Centocor) .
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-IL-6 Receptor (IL-6R) agent or antibody examples include without limitation: Tocilizumab, R-1569 (Actemra/Chugai Pharmaceutical; Osaka University), or AS-101 (CB-06- 02, IVX-Q-101).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-IL3RA CD 123 agent or antibody
  • anti- IL3RA (CD 123) agents or antibodies that can be co-administered include without limitation: tagraxofusp, talacotuzumab (JNJ-56022473; CSL362 (CSL)), pivekimab sunirine (IMGN632), MB- 102 (Mustang Bio), CSL360 (CSL); vibecotamab (XmAb 14045; Xencor); KHK2823 (Kyowa Hakko Kirin Co.); MGD-024 (CD123/CD3; Macrogenics), APVO436 (CD123/CD3); flotetuzumab (CD123/CD3); JNJ-63709178 (CD123/CD3); and XmAb-14045 (CD123/CD3) (Xencor).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-IL2RA agent or antibody examples include without limitation: Basiliximab, SDZ-CHL621 (Simulect/Novartis), and Daclizumab.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-IGF-lR CD221 agent or antibody
  • anti-IGF-1R agents or antibodies that can be co-administered include without limitation: Ganitumab, AMG-479 (Amgen); Ganitumab, AMG-479 (Amgen), Dalotuzumab, MK-0646 (Pierre Fabre), and AVE 1642 (Immuno Gen).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • CSF2 anti-GM-CSF
  • anti-GM-CSF agents or antibodies that can be co-administered include without limitation: Lenzilumab (a.k.a., KB003; KaloBios Pharmaceuticals).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-HGF agent or antibody examples include without limitation: Ficlatuzumab, AV-299 (AVEO Pharmaceuticals).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD44 agent or antibody examples include without limitation: RG7356, RO5429083 (Chugai Biopharmaceuticals; Roche).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-VLA-4 agent or antibody examples include without limitation: Natalizumab, BG-0002-E (Tysabri/Elan Corporation).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-ICAM-1 (CD54) agent or antibody examples include without limitation: BI-505 (BioInvent International).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-VEGF-A agent or antibody examples include without limitation: Bevacizumab (Avastin/Genentech; Hackensack University Medical Center).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-Endo sialin agent or antibody examples include without limitation: Ontecizumab, MORAB-004 (Ludwig Institute for Cancer Research; Morphotek).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-CD79 agent or antibody examples include without limitation: polatuzumab, DCDS4501A, RG7596 (Genentech).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti- Isocitrate dehydrogenase (IDH) agent or antibody examples include without limitation: IDH1 inhibitor ivosidenib (Tibsovo; Agios) and the IDH2 inhibitor enasidenib (Idhifa; Celgene/ Agios).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-major histocompatibility complex, class I, G HLA-G; NCBI Gene ID: 3135
  • TTX-080 an anti-major histocompatibility complex, class I, G (HLA-G; NCBI Gene ID: 3135) antibody
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an anti-leukocyte immunoglobulin like receptor B2 LILRB2, a.k.a., CD85D, ILT4; NCBI Gene ID: 10288) antibody, such as JTX-8064 or MK-4830.
  • TNF Receptor Superfamily (TNFRSF) Member Agonists or Activators
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab); and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, is further combined with an agonist of one or more TNF receptor superfamily (TNFRSF) members, e.g., an agonist of one or more of TNFRSF1A (NCBI Gene ID: 7132), TNFRSF1B (NCBI Gene ID: 7133), TNFRSF4 (0X40, CD134; NCBI Gene ID: 7293), TNFRSF5 (CD40; NCBI Gene ID: 958), TNFRSF6 (FAS, NCBI Gene ID: 355), TNFRSF7 (CD27, NCBI Gene ID: 939), TNFRSF8 (CD30, NCBI Gene ID: 943), TNFRSF9 (4-1BB, CD137, NCBI Gene ID: 3604), TNFRSF10A (CD261, DR4,
  • TNFRSF10A CD
  • anti-TNFRSF4 (0X40) antibodies that can be co-administered include without limitation, MEDI6469, MEDI6383, MEDI0562 (tavolixizumab), MOXR0916, PF- 04518600, RG-7888, GSK-3174998, INCAGN1949, BMS-986178, GBR-8383, ABBV-368, and those described in WO2016179517, WO2017096179, WO2017096182, WO2017096281, and WO2018089628, each of which is hereby incorporated by reference in its entirety.
  • anti-TNF receptor superfamily member 10b examples include without limitation, such as DS-8273, CTB-006, INB RX- 109, and GEN- 1029.
  • anti-TNFRSF5 (CD40) antibodies examples include without limitation selicrelumab (R07009789), mitazalimab (a.k.a., vanalimab, ADC- 1013, JNJ-64457107), RG7876, SEA-CD40, APX-005M and ABBV-428, ABBV-927, and JNJ- 64457107.
  • anti-TNFRSF7 CD27
  • varlilumab CDX-1127
  • anti-TNFRSF9 (4-1BB, CD137) antibodies examples include without limitation urelumab, utomilumab (PF-05082566), AGEN2373, and ADG-106, BT-7480, and QL1806.
  • anti-TNFRSF17 examples include without limitation GSK-2857916.
  • anti-TNFRSF18 (GITR) antibodies examples include without limitation, MEDI1873, FPA-154, INCAGN-1876, TRX-518, BMS-986156, MK-1248, GWN-323, and those described in WO2017096179, WO2017096276, WO2017096189, and WO2018089628.
  • an antibody, or fragment thereof, co-targeting TNFRSF4 (0X40) and TNFRSF18 (GITR) is co-administered.
  • Such antibodies are described, e.g., in WO2017096179 and WO2018089628, each of which is hereby incorporated by reference in its entirety.
  • Example anti-TRAILRl, anti-TRAILR2, anti-TRAILR3, anti-TRAILR4 antibodies that can be co-administered include without limitation ABBV-621.
  • Bi-specific antibodies targeting TNFRSF family members include without limitation PRS-343 (CD-137/HER2), AFM26 (BCMA/CD16A), AFM-13 (CD16/CD30), REGN-1979 (CD20/CD3), AMG-420 (BCMA/CD3), INHIBRX-105 (4-1BB/PDL1), FAP-4-IBBL (4-1BB/FAP), XmAb-13676 (CD3/CD20), RG-7828 (CD20/CD3), CC-93269 (CD3/BCMA), REGN-5458 (CD3/BCMA), and IMM-0306 (CD47/CD20), and AMG-424 (CD38.CD3).
  • inhibitors of PVR related immunoglobulin domain containing include without limitation: COM-701.
  • inhibitors of T cell immunoreceptor with Ig and ITIM domains include without limitation: BMS- 986207, RG-6058, AGEN-1307, and COM-902, etigilimab, tiragolumab (a.k.a., MTIG-7192A; RG-6058; RO 7092284), AGEN1777, IB 1-939, AB 154, MG1131 and EOS884448 (EOS-448).
  • inhibitors of hepatitis A virus cellular receptor 2 include without limitation: cobolimab (TSR-022), LY-3321367, sabatolimab (MBG-453), INCAGN-2390, RO-7121661 (PD-l/TIM-3), LY- 3415244 (TIM-3/PDL1), and RG7769 (PD-l/TIM-3).
  • inhibitors of lymphocyte activating 3 include without limitation: relatlimab (ONO-4482), LAG-525, MK-4280, REGN-3767, INCAGN2385, TSR-033, MGD-013 (PD-l/LAG-3), and FS-118 (LAG-3/PD-L1).
  • anti-killer cell immunoglobulin like receptor three Ig domains and long cytoplasmic tail 1 (KIR3DL1; KIR; NCBI Gene ID: 3811) monoclonal antibodies, such as lirilumab (IPH-2102), and IPH-4102.
  • anti-NKG2a antibodies that can be co-administered include without limitation: monalizumab.
  • anti-V-set immunoregulatory receptor (VSIR, B7H5, VISTA) antibodies that can be co-administered include without limitation: HMBD-002, and CA-170 (PD-L1/VISTA).
  • anti-CD70 antibodies examples include without limitation: AMG-172.
  • anti-ICOS antibodies examples include without limitation: JTX-2011, GSK3359609.
  • ICOS-L.COMP ICOS-L.COMP
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab); and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, is further combined with one or more immune checkpoint inhibitors.
  • the one or more immune checkpoint inhibitors is a proteinaceous (e.g., antibody or fragment thereof, or antibody mimetic) inhibitor of PD-L1 (CD274), PD-1 (PDCD1) or CTLA4.
  • the one or more immune checkpoint inhibitors comprises a small organic molecule inhibitor of PD-L1 (CD274), PD-1 (PDCD1) or CTLA4.
  • inhibitors of CTLA4 include without limitation ipilimumab, tremelimumab, BMS-986218, AGEN1181, AGEN1884, BMS-986249, MK-1308, REGN-4659, ADU-1604, CS-1002, BCD-145, APL-509, JS-007, BA-3071, ONC- 392, AGEN-2041, JHL-1155, KN-044, CG-0161, ATOR-1144, PBI-5D3H5, BPI-002, HBM- 4003, as well as multi- specific inhibitors FPT-155 (CTLA4/PD-L1/CD28), PF-06936308 (PD-1/CTLA4), MGD-019 (PD-1/CTLA4), KN-046 (PD-1/CTLA4), MEDI-5752 (CTLA4/PD- 1), XmAb-20717 (PD-1/CTLA4), and AK-104 (CTLA4/PD
  • inhibitors/antibodies of PD-L1 (CD274) or PD-1 (PDCD1) that can be co-administered include without limitation zimberelimab, pembrolizumab (KEYTRUDA®, MK-3477), nivolumab (OPDIVO®, BMS-936558, MDX-1106), cemiplimab, pidilizumab, spartalizumab (PDR-001), atezolizumab (RG-7446; TECENTRIQ, MPDL3280A), durvalumab (MEDI-4736), avelumab (MSB0010718C), tislelizumab (BGB-A317), toripalimab (JS-001), genolimzumab (CBT-501), camrelizumab (SHR-1210), dostarlimab (TSR-042), sintilimab (IBI- 308), tislelizumab (B
  • an anti-CD47 agent as described herein is combined with an inhibitor of MCL1 apoptosis regulator, BCL2 family member (MCL1, TM; EAT; MCL1L; MCL1S; Mcl-1; BCL2L3; MCL1-ES; bcl2-L-3; mcll/EAT; NCBI Gene ID: 4170).
  • MCL1 inhibitors include AMG-176, AMG-397, S-64315, and AZD-5991, 483- LM, A-1210477, UMI-77, JKY-5-037, and those described in WO2018183418, WO2016033486, and W02017147410.
  • TLR Toll-Like Receptor
  • an anti-CD47 agent or an anti-SIRPa agent as described herein is combined with an agonist of a toll-like receptor (TLR), e.g., an agonist of TLR1 (NCBI Gene ID: 7096), TLR2 (NCBI Gene ID: 7097), TLR3 (NCBI Gene ID: 7098), TLR4 (NCBI Gene ID: 7099), TLR5 (NCBI Gene ID: 7100), TLR6 (NCBI Gene ID: 10333), TLR7 (NCBI Gene ID: 51284), TLR8 (NCBI Gene ID: 51311), TLR9 (NCBI Gene ID: 54106), and/or TLR10 (NCBI Gene ID: 81793).
  • TLR toll-like receptor
  • Example TLR7 agonists that can be co-administered include without limitation DS-0509, GS-9620, LHC- 165, TMX-101 (imiquimod), GSK-2245035, resiquimod, DSR-6434, DSP-3025, IMO-4200, MCT-465, MEDI-9197, 3M-051, SB-9922, 3M- 052, Limtop, TMX-30X, TMX-202, RG-7863, RG-7795, and the compounds disclosed in US20100143301 (Gilead Sciences), US20110098248 (Gilead Sciences), and US20090047249 (Gilead Sciences), US20140045849 (Janssen), US20140073642 (Janssen), WO2014/056953 (Janssen), WO2014/076221 (Janssen), WO2014/128189 (Janssen), US20140350031 (Janssen), WO2014/023813 (Janssen), US
  • TLR7/TLR8 agonist that can be co-administered is NKTR-262.
  • Example TLR8 agonists that can be co-administered include without limitation E-6887, IMO-4200, IMO-8400, IMO-9200, MCT-465, MEDI-9197, motolimod, resiquimod, GS-9688, VTX-1463, VTX-763, 3M-051, 3M- 052, and the compounds disclosed in US20140045849 (Janssen), US20140073642 (Janssen), WO2014/056953 (Janssen), WO2014/076221 (Janssen), WO2014/128189 (Janssen), US20140350031 (Janssen), WO2014/023813 (Janssen), US20080234251 (Array Biopharma), US20080306050 (Array Biopharma), US20100029585 (Ventirx Pharma), US20110092485 (Ventirx Pharma), US
  • Example TLR9 agonists that can be co-administered include without limitation AST-008, CMP-001, IMO-2055, IMO-2125, litenimod, MGN-1601, BB-001, BB-006, IMO- 3100, IMO-8400, IR-103, IMO-9200, agatolimod, DIMS-9054, DV-1079, DV-1179, AZD- 1419, leftolimod (MGN-1703), CYT-003, CYT-003-QbG10 and PUL-042.
  • TLR3 agonist examples include rintatolimod, poly-ICLC, RIBOXXON®, Apoxxim, RIBOXXIM®, IPH-33, MCT-465, MCT-475, and ND- 1.1.
  • TLR8 inhibitors include, but are not limited to, E-6887, IMO-8400,
  • TLR8 agonists include, but are not limited to, MCT-465, motolimod, GS-9688, and VTX-1463.
  • TLR9 agonists include but are not limited to, AST-008, IMO-2055,
  • TLR7/TLR8 agonists include without limitation NKTR-262, IMO-
  • TLR agonists include without limitation: lefitolimod, tilsotolimod, rintatolimod, DSP-0509, AL-034, G-100, cobitolimod, AST-008, motolimod, GSK-1795091, GSK-2245035, VTX-1463, GS-9688, LHC-165, BDB-001, RG-7854, telratolimod.
  • the therapeutic agent is a stimulator of interferon genes (STING)
  • STING receptor agonist or activator is selected from ADU- S100 (MIW-815), SB-11285, MK-1454, SR-8291, AdVCA0848, GSK-532, SYN-STING, MSA-1, SR-8291, 5,6-dimethylxanthenone-4-acetic acid (DMXAA), cyclic-GAMP (cGAMP), and cyclic-di-AMP.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • TCR T-Cell Receptor
  • TCR signaling modulators include without limitation CD2 (cluster of differentiation 2, LFA-2, Ti l, LFA-3 receptor), CD3 (cluster of differentiation 3), CD4 (cluster of differentiation 4), CD8 (cluster of differentiation 8), CD28 (cluster of differentiation 28), CD45 (PTPRC, B220, GP180), LAT (Linker for activation of T cells, LAT1), Lek, LFA-1 (ITGB2, CD18, LAD, LCAMB), Src, Zap-70, SLP-76, DGKalpha, CBL-b, CISH, HPK1.
  • Examples of agonist of cluster of differentiation 3 (CD3) that can be coadministered include without limitation MGD015.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • Blockade or inhibition of inhibitory immune checkpoints can positively regulate T-cell or NK cell activation and prevent immune escape of cancer cells within the tumor microenvironment.
  • Activation or stimulation of stimulatory immune check points can augment the effect of immune checkpoint inhibitors in cancer therapeutics.
  • the immune checkpoint proteins or receptors regulate T cell responses (e.g., reviewed in Xu, et al., J Exp Clin Cancer Res. (2016) 37:110). In various embodiments, the immune checkpoint proteins or receptors regulate NK cell responses (e.g., reviewed in Davis, et al., Semin Immunol. (2017) 31:64-75 and Chiossone, et al., Nat Rev Immunol. (2016) 18(11):671-688).
  • immune checkpoint proteins or receptors include without limitation CD27, CD70; CD40, CD40LG; CD47, CD48 (SLAMF2), transmembrane and immunoglobulin domain containing 2 (TMIGD2, CD28H), CD84 (LY9B, SLAMF5), CD96, CD160, MS4A1 (CD20), CD244 (SEAMF4); CD276 (B7H3); V-set domain containing T cell activation inhibitor 1 (VTCN1, B7H4); V-set immunoregulatory receptor (VSIR, B7H5, VISTA); immunoglobulin superfamily member 11 (IGSF11, VSIG3); natural killer cell cytotoxicity receptor 3 ligand 1 (NCR3EG1, B7H6); HERV-H ETR-associating 2 (HHLA2, B7H7); inducible T cell costimulator (ICOS, CD278); inducible T cell costimulator ligand (ICOSEG, B7H2); TNF receptor superfamily member
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • one or more blockers or inhibitors of one or more T-cell inhibitory immune checkpoint proteins or receptors is further combined with one or more blockers or inhibitors of one or more T-cell inhibitory immune checkpoint proteins or receptors.
  • T-cell inhibitory immune checkpoint proteins or receptors include without limitation CD274 (PDL1, PD-L1); programmed cell death 1 ligand 2 (PDCD1LG2, PD-L2, CD273); programmed cell death 1 (PDCD1, PD1, PD-1); cytotoxic T-lymphocyte associated protein 4 (CTLA4, CD152); CD276 (B7H3); V-set domain containing T cell activation inhibitor 1 (VTCN1, B7H4); V-set immunoregulatory receptor (VSIR, B7H5, VISTA); immunoglobulin superfamily member 11 (IGSF11, VSIG3); TNFRSF14 (HVEM, CD270), TNFSF14 (HVEML); CD272 (B and T lymphocyte associated (BTLA)); PVR related immunoglobulin domain containing (PVRIG, CD112R); T cell immunoreceptor with Ig and ITIM domains (TIGIT); lymphocyte activating 3 (LAG-3, CD223); hepatitis A virus
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • one or more agonist or activators of one or more T-cell stimulatory immune checkpoint proteins or receptors is further combined with one or more agonist or activators of one or more T-cell stimulatory immune checkpoint proteins or receptors.
  • T-cell stimulatory immune checkpoint proteins or receptors include without limitation CD27, CD70; CD40, CD40LG; inducible T cell costimulator (ICOS, CD278); inducible T cell costimulator ligand (ICOSLG, B7H2); TNF receptor superfamily member 4 (TNFRSF4, 0X40); TNF superfamily member 4 (TNFSF4, OX40L); TNFRSF9 (CD137), TNFSF9 (CD137L); TNFRSF18 (GITR), TNFSF18 (GITRL); CD80 (B7-1), CD28; nectin cell adhesion molecule 2 (NECTIN2, CD112); CD226 (DNAM-1); CD244 (2B4, SLAMF4), Poliovirus receptor (PVR) cell adhesion molecule (PVR, CD155).
  • CD27, CD70; CD40, CD40LG inducible T cell costimulator (ICOS, CD278); inducible T cell costimulator ligand (ICOSLG, B
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • one or more blockers or inhibitors of one or more NK-cell inhibitory immune checkpoint proteins or receptors is further combined with one or more blockers or inhibitors of one or more NK-cell inhibitory immune checkpoint proteins or receptors.
  • Illustrative NK-cell inhibitory immune checkpoint proteins or receptors include without limitation killer cell immunoglobulin like receptor, three Ig domains and long cytoplasmic tail 1 (KIR, CD158E1); killer cell immunoglobulin like receptor, two Ig domains and long cytoplasmic tail 1 (KIR2DL1); killer cell immunoglobulin like receptor, two Ig domains and long cytoplasmic tail 2 (KIR2DL2); killer cell immunoglobulin like receptor, two Ig domains and long cytoplasmic tail 3 (KIR2DL3); killer cell immunoglobulin like receptor, three Ig domains and long cytoplasmic tail 1 (KIR3DL1); killer cell lectin like receptor Cl (KLRC1, NKG2A, CD159A); and killer cell lectin like receptor DI (KLRD1, CD94).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • one or more agonist or activators of one or more NK-cell stimulatory immune checkpoint proteins or receptors include without limitation CD 16, CD226 (DNAM-1); CD244 (2B4, SLAMF4); killer cell lectin like receptor KI (KLRK1, NKG2D, CD314); SLAM family member 7 (SLAMF7).
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab); and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, is further combined with an agonist or antagonist of AIR, A2AR, A2BR, A3R, CD73, CD39, CD26; e.g., Adenosine A3 receptor (A3R) agonists, such as namodenoson (CF102); A2aR/A2bR antagonists, such as AB928; anti-CD73 antibodies, such as MEDL9447 (oleclumab), CPX-006, IPH-53, BMS-986179, NZV-930, CPI-006; CD73 inhibitors, such as AB-680, PSB-12379, PSB-12441, PSB-12425, CB-708, and those described in Int Patent Publication No.
  • CD39/CD73 inhibitors such as PBF-1662; anti-CD39 antibodies, such as TTX-030; adenosine A2A receptor antagonists, such as CPI-444, AZD-4635, preladenant, PBF-509; and adenosine deaminase inhibitors, such as pentostatin, cladribine.
  • Bi-Specific T-Cell Engagers such as PBF-1662; anti-CD39 antibodies, such as TTX-030; adenosine A2A receptor antagonists, such as CPI-444, AZD-4635, preladenant, PBF-509; and adenosine deaminase inhibitors, such as pentostatin, cladribine.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • a bi-specific T-cell engager e.g., not having an Fc
  • an anti- CD3 bi-specific antibody e.g., having an Fc
  • Illustrative anti-CD3 bi-specific antibodies or BiTEs that can be co-administered include AMG-160 (PSMA/CD3), AMG-212 (PSMA/CD3), AMG-330 (CD33/CD3), AMG-420 (BCMA/CD3), AMG-427 (FET3/CD3), AMG-562 (CD19/CD3), AMG-596 (EGFRvIII/CD3), AMG-701 (BCMA/CD3), AMG-757 (DEE3/CD3), JNJ-64052781 (CD19/CD3), AMG-211 (CEA/CD3), BEINCYTO® (CD19/CD3), RG7802 (CEA/CD3), ERY-974 (CD3/GPC3), huGD2-BsAb (CD3/GD2), PF-06671008 (Cadherins/CD3), APVO436 (CD123/CD3), ERY974, flotetuzumab (CD123/CD3), GEM333
  • the anti-CD3 binding bi-specific molecules may or may not have an Fc.
  • Illustrative bi-specific T-cell engagers that can be co-administered target CD3 and a tumor-associated antigen as described herein, including, e.g., CD19 (e.g., blinatumomab); CD33 (e.g., AMG33O); CEA (e.g., MEDI-565); receptor tyrosine kinase-like orphan receptor 1 (ROR1) (Gohil, et al., Oncoimmunology. (2017) May 17;6(7):el326437); PD-L1 (Horn, et al., Oncotarget. 2017 Aug 3;8(35):57964-57980); and EGFRvIII (Yang, et al., Cancer Lett. 2017 Sep 10;403:224-230).
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab); and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, is further combined with a bi-specific NK-cell engager (BiKE) or a tri-specific NK-cell engager (TriKE) (e.g., not having an Fc) or bi-specific antibody (e.g., having an Fc) against an NK cell activating receptor, e.g., CD16A, C-type lectin receptors (CD94/NKG2C, NKG2D, NKG2E/H and NKG2F), natural cytotoxicity receptors (NKp30, NKp44 and NKp46), killer cell C-type lectin-like receptor (NKp65, NKp80), Fc receptor FcyR (which mediates antibodydependent cell cytotoxicity), SLAM family receptors (e.g., 2
  • Illustrative anti-CD16 bi-specific antibodies, BiKEs or TriKEs that can be coadministered include AFM26 (BCMA/CD16A) and AFM-13 (CD16/CD30). As appropriate, the anti-CD16 binding bi-specific molecules may or may not have an Fc.
  • BiKEs and TriKEs are described, e.g., in Felices, et al., Methods Mol Biol. (2016) 1441:333-346; Fang, et al., Semin Immunol. (2017) 31:37-54.
  • HPK1 Hematopoietic Progenitor Kinase 1
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of mitogen-activated protein kinase kinase kinase kinase 1 MAP4K1, HPK1; NCBI Gene ID: 11184.
  • Hematopoietic Progenitor Kinase 1 (HPK1) inhibitors include without limitation, those described in WO-2018183956, WO-2018183964, WO-2018167147, WO-2018183964, WO-2016205942, WO-2018049214, WO-2018049200, WO-2018049191, WO-2018102366, WO-2018049152, W02020092528, W02020092621 and WO-2016090300.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of an ASK inhibitor e.g., mitogen-activated protein kinase kinase kinase 5 (MAP3K5; ASK1, MAPKKK5, MEKK5; NCBI Gene ID: 4217).
  • ASK inhibitors include without limitation, those described in WO 2011/008709 (Gilead Sciences) and WO 2013/112741 (Gilead Sciences).
  • BTK Bruton Tyrosine Kinase
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • BTK Bruton tyrosine kinase
  • BTK inhibitors include without limitation, (S)-6-amino-9-(l-(but-2-ynoyl)pyrrolidin-3-yl)-7-(4- phenoxyphenyl)-7H-purin-8(9H)-one, acalabrutinib (ACP-196), BGB-3111, CB988, HM71224, ibrutinib (Imbruvica), M-2951 (evobrutinib), M7583, tirabrutinib (ONO-4059), PRN-1008, spebrutinib (CC-292), TAK-020, vecabrutinib, ARQ-531, SHR-1459, DTRMWXHS-12, TAS- 5315, Calquence + AZD6738, Calquence + danvatirsen.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of cyclin dependent kinase 1 CDK1, CDC2; CDC28A; P34CDC2; NCBI Gene ID: 983
  • cyclin dependent kinase 2 CDK2, CDKN2; p33(CDK2); NCBI Gene ID: 1017
  • cyclin dependent kinase 3 CDK3; NCBI Gene ID: 1018
  • cyclin dependent kinase 4 CDK4, CMM3; PSK-J3; NCBI Gene ID: 1019
  • cyclin dependent kinase 6 CDK6, MCPH12; PLSTIRE; NCBI Gene ID: 1021
  • cyclin dependent kinase 7 CDK7, CAK; CAK1; HCAK
  • Inhibitors of CDK 1, 2, 3, 4, 6, 7 and/or 9 include without limitation abemaciclib, alvocidib (HMR-1275, flavopiridol), AT-7519, dinaciclib, ibrance, FLX-925, LEE001, palbociclib, ribociclib, rigosertib, selinexor, UCN-01, SY1365, CT-7001, SY-1365, G1T38, milciclib, trilaciclib, PF-06873600, AZD4573, and TG-02.
  • DDR Discoidin Domain Receptor
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of discoidin domain receptor tyrosine kinase 1 DDR1, CAK, CD167, DDR, EDDR1, HGK2, MCK10, NEP, NTRK4, PTK3, PTK3A, RTK6, TRKE; NCBI Gene ID: 780
  • discoidin domain receptor tyrosine kinase 2 DDR2, MIG20a, NTRKR3, TKT, TYRO10, WRCN; NCBI Gene ID: 4921
  • DDR inhibitors include without limitation, dasatinib and those disclosed in WO2014/047624 (Gilead Sciences), US 2009-0142345 (Takeda Pharmaceutical), US 2011-0287011 (Oncomed Pharmaceuticals), WO 2013/027802 (Chugai Pharmaceutical), and WO2013/034933 (Imperial Innovations).
  • HD AC Histone Deacetylase
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of a histone deacetylase e.g., histone deacetylase 9 (HDAC9, HD7, HD7b, HD9, HDAC, HDAC7, HDAC7B, HDAC9B, HDAC9FL, HDRP, MITR; Gene ID: 9734).
  • HDAC inhibitors include without limitation, abexinostat, ACY-241, AR-42, BEBT-908, belinostat, CKD-581, CS-055 (HBI-8000), CUDC-907 (fimepinostat), entinostat, givinostat, mocetinostat, panobinostat, pracinostat, quisinostat (JNJ- 26481585), resminostat, ricolinostat, SHP-141, valproic acid (VAL-001), vorinostat, tinostamustine, remetinostat, entinostat, romidepsin, tucidinostat.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • IDO1 indoleamine 2,3-dioxygenase 1
  • IDO1 inhibitors include without limitation, BLV-0801, epacadostat, F-001287, GBV-1012, GBV-1028, GDC-0919, indoximod, NKTR-218, NLG-919- based vaccine, PF-06840003, pyranonaphthoquinone derivatives (SN-35837), resminostat, SBLK-200802, BMS-986205, and shlDO-ST, EOS-200271, KHK-2455, LY-3381916.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of Janus kinase 1 JAK1, JAK1A, JAK1B, JTK3; NCBI Gene ID: 3716
  • Janus kinase 2 JTK2, JTK10, THCYT3; NCBI Gene ID: 3717
  • Janus kinase 3 JAK3, JAK-3, JAK3_HUMAN, JAKL, L-JAK, LJAK; NCBI Gene ID: 3718.
  • JAK inhibitors include without limitation, AT9283, AZD1480, baricitinib, BMS- 911543, fedratinib, filgotinib (GLPG0634), gandotinib (LY2784544), INCB039110 (itacitinib), lestaurtinib, momelotinib (CYT0387), NS-018, pacritinib (SB 1518), peficitinib (ASP015K), ruxolitinib, tofacitinib (formerly tasocitinib), INCB052793, and XL019.
  • MMP Matrix Metalloprotease
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of a matrix metallopeptidase e.g., an inhibitor of MMP1 (NCBI Gene ID: 4312), MMP2 (NCBI Gene ID: 4313), MMP3 (NCBI Gene ID: 4314), MMP7 (NCBI Gene ID: 4316), MMP8 (NCBI Gene ID: 4317), MMP9 (NCBI Gene ID: 4318); MMP10 (NCBI Gene ID: 4319); MMP11 (NCBI Gene ID: 4320); MMP12 (NCBI Gene ID: 4321), MMP13 (NCBI Gene ID: 4322), MMP14 (NCBI Gene ID: 4323), MMP15 (NCBI Gene ID: 4324), MMP16 (NCBI Gene ID: 4325), MMP17 (MMP1) (NCBI Gene ID: 4312), MMP2 (NCBI Gene ID
  • MMP9 inhibitors include without limitation, marimastat (BB-2516), cipemastat (Ro 32-3555), GS-5745 (andecaliximab) and those described in WO 2012/027721 (Gilead Biologies).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • KRAS KRAS proto-oncogene
  • GTPase GTPase
  • NS NS3; CFC2; RALD; K-Ras; KRAS1; KRAS2; RASK2; KI-RAS; C-K-RAS; K-RAS2A; K- RAS2B; K-RAS4A; K-RAS4B; c-Ki-ras2; NCBI Gene ID: 3845); NRAS proto-oncogene, GTPase (NRAS; a.k.a., NS6; CMNS; NCMS; ALPS4; N-ras; NRAS1; NCBI Gene ID: 4893); HRas proto-oncogene, GTPase (HRAS; a.k.a., CTLO; KRAS; HAMSV; HRAS1; KRAS2; RASH1; RASK2; Ki-Ras; p21ras; C-H-RAS; c-K-ras; H-RASIDX; c-Ki-
  • the Ras inhibitors can inhibit Ras at either the polynucleotide (e.g., transcriptional inhibitor) or polypeptide (e.g., GTPase enzyme inhibitor) level.
  • the inhibitors target one or more proteins in the Ras pathway, e.g., inhibit one or more of EGFR, Ras, Raf (A-Raf, B-Raf, C-Raf), MEK (MEK1, MEK2), ERK, PI3K, AKT and mTOR.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • KRAS inhibitors examples include AMG-510, COTI-219, MRTX-1257, ARS-3248, ARS-853, WDB-178, BI-3406, BI-1701963, ARS-1620 (G12C), SML-8-73-1 (G12C), Compound 3144 (G12D), Kobe0065/2602 (Ras GTP), RT11, MRTX-849 (G12C) and K-Ras(G12D)-selective inhibitory peptides, including KRpep-2 (Ac-RRCPLYISYDPVCRR-NH2) (SEQ ID NO: 256) and KRpep-2d (Ac- RRRRCPLYISYDPVCRRRR-NH2) (SEQ ID NO: 257).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • KRAS mRNA inhibitors include anti-KRAS U1 adaptor, AZD-4785, siG12D-L0DERTM, and siG12D exosomes.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of MEK e.g., acetyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl-N-phenyl
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of AKT e.g., RI-6, RI-6, RI-6, RI-6, RI-6, RI-6, RI-6, RI-6, RI-6, RI-6, RI-6, RI-6, RI-6, and RI-092, capivasertib, triciribine, ABTL-0812 (PI3K/Akt/mTOR).
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of Raf is further combined with an inhibitor of Raf.
  • Illustrative Raf inhibitors that can be coadministered BGB-283 (Raf/EGFR), HM-95573, LXH-254, LY-3009120, RG7304, TAK-580, dabrafenib, vemurafenib, encorafenib (LGX818), PLX8394.
  • RAF-265 Raf/VEGFR
  • ASN-003 Raf/PI3K
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of ERK e.g., ERK inhibitors that can be coadministered include LTT-462, LY-3214996, MK-8353, ravoxertinib, GDC-0994, and ulixertinib.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of PI3K e.g., PI3K inhibitors that can be co-administered include idelalisib (Zydelig®), alpelisib, buparlisib, pictilisib, eganelisib (IPI- 549).
  • Illustrative PI3K/mT0R inhibitors that can be co-administered include dactolisib, omipalisib, voxtalisib, gedatolisib, GSK2141795, RG6114.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of mTOR e.g., mTOR inhibitors that can be co-administered include as sapanisertib, vistusertib (AZD2014), ME-344, sirolimus (oral nano- amorphous formulation, cancer), TYME-88 (mTOR/cytochrome P450 3A4).
  • Ras-driven cancers having CDKN2A mutations can be inhibited by co-administration of the MEK inhibitor selumetinib and the CDK4/6 inhibitor palbociclib.
  • the MEK inhibitor selumetinib and the CDK4/6 inhibitor palbociclib See, e.g., Zhou, et al., Cancer Lett. 2017 Nov 1 ;408: 130- 137.
  • K-RAS and mutant N-RAS can be reduced by the irreversible ERBB 1/2/4 inhibitor neratinib. See, e.g., Booth, et al., Cancer Biol Ther. 2018 Feb 1 ; 19(2): 132- 137.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • RAS inhibitors include NEO- 100 and rigosertib.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an antagonist of EGFR such as AMG-595, necitumumab, ABBV-221, depatuxizumab mafodotin (ABT-414), tomuzotuximab, ABT-806, vectibix, modotuximab, RM-1929.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of protein tyrosine phosphatase non-receptor type 11 PTPN11; BPTP3, CFC, JMML, MC7CDS, NS1, PTP-1D, PTP2C, SH-PTP2, SH-PTP3, SHP2; NCBI Gene ID: 5781).
  • SHP2 inhibitors include TNO155 (SHP-099), RMC-4550, JAB-3068, RMC-4630, SAR442720 and those described in WO2018172984 and W02017211303.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of mitogen-activated protein kinase 7 MAP2K7, JNKK2, MAPKK7, MEK, MEK 7, MKK7, PRKMK7, SAPKK-4, SAPKK4; NCBI Gene ID: 5609.
  • MEK inhibitors include antroquinonol, binimetinib, CK-127, cobimetinib (GDC-0973, XL-518), MT-144, selumetinib (AZD6244), sorafenib, trametinib (GSK1120212), uprosertib + trametinib, PD-0325901, pimasertib, LTT462, AS703988, CC-90003, refametinib, TAK-733, CI-1040, RG7421.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of a phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit e.g., phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA, CLAPO, CLOVE, CWS5, MCAP, MCM, MCMTC, PI3K, PI3K-alpha, pllO-alpha; NCBI Gene ID: 5290); phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta (PIK3CB, P110BETA, PI3K, PI3KBETA, PIK3C1; NCBI Gene ID: 52
  • the PI3K inhibitor is a pan-PI3K inhibitor.
  • PI3K inhibitors include without limitation, ACP-319, AEZA-129, AMG-319, AS252424, AZD8186, BAY 1082439, BEZ235, bimiralisib (PQR309), buparlisib (BKM120), BYL719 (alpelisib), carboxyamidotriazole orotate (CTO), CH5132799, CLR-457, CLR-1401, copanlisib (BAY 80-6946), DS-7423, dactolisib, duvelisib (IPL145), fimepinostat (CUDC-907), gedatolisib (PF-05212384), GDC-0032, GDC-0084 (RG7666), GDC-0077, pictilisib (GDC-0941), GDC-0980, GSK2636771, GSK2269577
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • SYK spleen associated tyrosine kinase
  • SYK inhibitors include without limitation, 6-(lH-indazol-6- yl)-N-(4-morpholinophenyl)imidazo[l,2-a]pyrazin-8-amine, BAY-61-3606, cerdulatinib (PRT- 062607), entospletinib, fostamatinib (R788), HMPL-523, NVP-QAB 205 AA, R112, R343, tamatinib (R406), and those described in US 8450321 (Gilead Connecticut) and those described in U.S. 2015/0175616.
  • TKIs Tyrosine-kinase Inhibitors
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • TKI tyrosine kinase inhibitor
  • TKIs may target epidermal growth factor receptors (EGFRs) and receptors for fibroblast growth factor (FGF), platelet- derived growth factor (PDGF), and vascular endothelial growth factor (VEGF).
  • EGFRs epidermal growth factor receptors
  • FGF fibroblast growth factor
  • PDGF platelet- derived growth factor
  • VEGF vascular endothelial growth factor
  • TKIs include without limitation, axitinib, afatinib, ARQ-087 (derazantinib), asp5878, AZD3759, AZD4547, bosutinib, brigatinib, cabozantinib, cediranib, crenolanib, crizotinib, dacomitinib, dasatinib, dovitinib, E-6201, erdafitinib, erlotinib, gefitinib, gilteritinib (ASP-2215), FP-1039, HM61713, icotinib, imatinib, KX2-391 (Src), lapatinib, lestaurtinib, lenvatinib, midostaurin, nintedanib, ODM-203, olmutinib, osimertinib (AZD-9291), pazopanib
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • a chemotherapeutic agent or anti-neoplastic agent is further combined with a chemotherapeutic agent or anti-neoplastic agent.
  • chemotherapeutic agent or “chemotherapeutic” (or “chemotherapy” in the case of treatment with a chemotherapeutic agent) is meant to encompass any non-proteinaceous (e.g., non-peptidic) chemical compound useful in the treatment of cancer.
  • chemotherapeutic agents include but not limited to: alkylating agents such as thiotepa and cyclophosphamide (CYTOXAN®); alkyl sulfonates such as busulfan, improsulfan, and piposulfan; aziridines such as benzodepa, carboquone, meturedepa, and uredepa; ethylenimines and methylamelamines including altretamine, triethylenemelamine, triethylenephosphoramide, triethylenethiophosphoramide, and trimemylolomelamine; acetogenins, e.g., bullatacin and bullatacinone; a camptothecin, including synthetic analog topotecan; bryostatin, callystatin; CC-1065, including its adozelesin, carzelesin, and bizelesin synthetic analogs; cryptophycins, particularly cryptophycin 1 and cryptophycin 8;dolastatin
  • calicheamicin especially calicheamicin gammall and calicheamicin phill
  • dynemicin including dynemicin A, bisphosphonates such as clodronate, an esperamicin, neocarzinostatin chromophore and related chromoprotein enediyne antibiotic chromomophores, aclacinomycins, actinomycin, authramycin, azaserine, bleomycins, cactinomycin, carabicin, carrninomycin, carzinophilin, chromomycins, dactinomycin, daunorubicin, detorubicin, 6-diazo- 5-oxo-L- norleucine, doxorubicin (including morpholino-doxorubicin, cyanomorpholinodoxorubicin, 2-pyrrolino-doxorubicin, and deoxy doxorubicin), epirubicin,
  • anti-hormonal agents such as anti-estrogens and selective estrogen receptor modulators (SERMs), inhibitors of the enzyme aromatase, anti-androgens, and pharmaceutically acceptable salts, acids or derivatives of any of the above that act to regulate or inhibit hormone action on tumors.
  • SERMs include, for example, tamoxifen (including NOLVADEXTM), raloxifene, droloxifene, 4-hydroxy tamoxifen, trioxifene, keoxifene, LY 117018, onapristone, and toremifene (FARESTON®).
  • Inhibitors of the enzyme aromatase regulate estrogen production in the adrenal glands include 4(5)-imidazoles, aminoglutethimide, megestrol acetate (MEGACE®), exemestane, formestane, fadrozole, vorozole (RIVISOR®), letrozole (FEMARA®), and anastrozole (ARIMIDEX®).
  • Examples of anti-androgens include apalutamide, abiraterone, enzalutamide, flutamide, galeterone, nilutamide, bicalutamide, leuprolide, goserelin, ODM-201, APC-100, ODM-204.
  • An example progesterone receptor antagonist includes onapristone.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • Anti-angiogenic agents that can be co-administered include, but are not limited to, retinoid acid and derivatives thereof, 2- methoxyestradiol, ANGIOSTATIN®, ENDOSTATIN®, regorafenib, necuparanib, suramin, squalamine, tissue inhibitor of metalloproteinase- 1, tissue inhibitor of metalloproteinase-2, plasminogen activator inhibitor- 1, plasminogen activator inbibitor-2, cartilage-derived inhibitor, paclitaxel (nab-paclitaxel), platelet factor 4, protamine sulphate (clupeine), sulphated chitin derivatives (prepared from queen crab shells), sulphated polysaccharide peptidoglycan complex (sp-pg), staurosporine, modulators of matrix metabolism including proline analogs such as 1- azetidine-2-carboxylic acid (LACA), cishydroxyproline, d,I-3,4-
  • anti-angiogenesis agents include antibodies, preferably monoclonal antibodies against these angiogenic growth factors: beta-FGF, alpha-FGF, FGF-5, VEGF isoforms, VEGF-C, HGF/SF, and Ang-l/Ang-2.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • Anti-fibrotic agents that can be coadministered include, but are not limited to, the compounds such as beta-aminoproprionitrile (BAPN), as well as the compounds disclosed in US 4965288 relating to inhibitors of lysyl oxidase and their use in the treatment of diseases and conditions associated with the abnormal deposition of collagen and US 4997854 relating to compounds which inhibit LOX for the treatment of various pathological fibrotic states, which are herein incorporated by reference.
  • BAPN beta-aminoproprionitrile
  • Exemplary anti-fibrotic agents also include the primary amines reacting with the carbonyl group of the active site of the lysyl oxidases, and more particularly those which produce, after binding with the carbonyl, a product stabilized by resonance, such as the following primary amines: emylenemamine, hydrazine, phenylhydrazine, and their derivatives; semicarbazide and urea derivatives; aminonitriles such as BAPN or 2-nitroethylamine; unsaturated or saturated haloamines such as 2-bromo-ethylamine, 2-chloroethylamine, 2- trifluoroethylamine, 3 -bromopropylamine, and p-halobenzylamines; and selenohomocysteine lactone.
  • primary amines reacting with the carbonyl group of the active site of the lysyl oxidases, and more particularly those which produce, after binding with the carbonyl,
  • anti-fibrotic agents are copper chelating agents penetrating or not penetrating the cells.
  • Exemplary compounds include indirect inhibitors which block the aldehyde derivatives originating from the oxidative deamination of the lysyl and hydroxylysyl residues by the lysyl oxidases.
  • Examples include the thiolamines, particularly D-penicillamine, and its analogs such as 2-amino-5-mercapto-5-methylhexanoic acid, D-2-amino-3-methyl-3-((2- acetamidoethyl)dithio)butanoic acid, p-2-amino-3-methyl-3-((2-aminoethyl)dithio)butanoic acid, sodium-4-((p-l-dimethyl-2-amino-2-carboxyethyl)dithio)butane sulphurate, 2- acetamidoethyl-2-acetamidoethanethiol sulphanate, and sodium-4-mercaptobutanesulphinate trihydrate.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • Example anti-inflammatory agents include without limitation inhibitors of one or more of arginase (ARG1 (NCBI Gene ID: 383), ARG2 (NCBI Gene ID: 384)), carbonic anhydrase (CAI (NCBI Gene ID: 759), CA2 (NCBI Gene ID: 760), CA3 (NCBI Gene ID: 761), CA4 (NCBI Gene ID: 762), CA5A (NCBI Gene ID: 763), CA5B (NCBI Gene ID: 11238), CA6 (NCBI Gene ID: 765), CA7 (NCBI Gene ID: 766), CA8 (NCBI Gene ID: 767), CA9 (NCBI Gene ID: 768), CA10 (NCBI Gene ID: 56934), CA11 (NCBI Gene ID: 770), CA12 (NCBI Gene ID: 771), CA I 3 (NCBI Gene ID: 377677), CA14 (NCBI Gene ID: 23632)), prostaglandin-endoperoxide synthase 1 (PTGS1, COX-1; NCBI Gene ID:
  • NCBI Gene ID: 5742 examples include without limitation mofezolac, GLY-230, and TRK-700.
  • inhibitors of prostaglandin-endoperoxide synthase 2 include without limitation diclofenac, meloxicam, parecoxib, etoricoxib, AP-101, celecoxib, AXS-06, diclofenac potassium, DRGT- 46, AAT-076, meisuoshuli, lumiracoxib, meloxicam, valdecoxib, zaltoprofen, nimesulide, Anitrazafen, Apricoxib, Cimicoxib, Deracoxib, Flumizole, Firocoxib, Mavacoxib, NS-398, Pamicogrel, Parecoxib, Robenacoxib, Rofe
  • Examples of dual COX1/COX2 inhibitors that can be co-administered include without limitation, HP-5000, lornoxicam, ketorolac tromethamine, bromfenac sodium, ATB-346, HP- 5000.
  • Examples of dual COX-2/carbonic anhydrase (CA) inhibitors that can be co-administered include without limitation polmacoxib and imrecoxib.
  • inhibitors of secreted phospholipase A2, prostaglandin E synthase include without limitation LY3023703, GRC 27864, and compounds described in WO2015158204, WO2013024898, W02006063466, W02007059610, WO2007124589, W02010100249, W02010034796, W02010034797, WO2012022793, WO2012076673, WO2012076672, W02010034798, W02010034799, WO2012022792, W02009103778, WO2011048004, WO2012087771, WO2012161965, W02013118071, WO2013072825, WO2014167444, WO2009138376, W02011023812, W02012110860, WO2013153535, W02009130242, WO2009146696, WO201318669
  • Metformin has further been found to repress the COX2/PGE2/STAT3 axis, and can be coadministered. See, e.g., Tong, et al., Cancer Lett. (2017) 389:23-32; and Liu, et al., Oncotarget. (2016) 7(19):28235-46.
  • inhibitors of carbonic anhydrase include without limitation acetazolamide, methazolamide, dorzolamide, zonisamide, brinzolamide and dichlorphenamide.
  • a dual COX-2/CA1/CA2 inhibitor that can be co-administered includes CG100649.
  • Examples of inhibitors of arachidonate 5-lipoxygenase (AL0X5, 5-LOX; NCBI Gene ID: 240) that can be co-administered include without limitation meclofenamate sodium, zileuton.
  • Examples of inhibitors of soluble epoxide hydrolase 2 (EPHX2, SEH; NCBI Gene ID: 2053) that can be co-administered include without limitation compounds described in WO2015148954.
  • Dual inhibitors of COX-2/SEH that can be co-administered include compounds described in WO2012082647.
  • Dual inhibitors of SEH and fatty acid amide hydrolase (FAAH; NCBI Gene ID: 2166) that can be co-administered include compounds described in W02017160861.
  • Examples of inhibitors of mitogen-activated protein kinase kinase kinase 8 that can be co-administered include without limitation GS-4875, GS-5290, BHM-078 and those described, e.g., in WO2006124944, WO2006124692, WO2014064215, W02018005435, Teli, et al., J Enzyme Inhib Med Chem. (2012) 27(4):558-70; Gangwall, et al., Curr Top Med Chem. (2013) 13(9): 1015-35; Wu, et al., Bioorg Med Chem Lett.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an agent that promotes or increases tumor oxygenation or reoxygenation, or prevents or reduces tumor hypoxia is further combined with an agent that promotes or increases tumor oxygenation or reoxygenation, or prevents or reduces tumor hypoxia.
  • Illustrative agents that can be coadministered include, e.g., Hypoxia inducible factor- 1 alpha (HIF-la) inhibitors, such as PT- 2977, PT-2385; VEGF inhibitors, such as bevasizumab, IMC-3C5, GNR-011, tanibirumab, LYN-00101, ABT-165; and/or an oxygen carrier protein (e.g., a heme nitric oxide and/or oxygen binding protein (HNOX)), such as OMX-302 and HNOX proteins described in WO 2007/137767, WO 2007/139791, WO 2014/107171, and WO 2016/149562.
  • HNF-la Hypoxia inducible factor- 1 alpha
  • HIF-la Hypoxia inducible factor- 1 alpha
  • VEGF inhibitors such as bevasizumab, IMC-3C5, GNR-011, tanibirumab, LYN-00101, ABT-165
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • Example immunotherapeutic agents that can be co-administered include without limitation abagovomab, AB P-980, adecatumumab, afutuzumab, alemtuzumab, altumomab, amatuximab, anatumomab, arcitumomab, bavituximab, bectumomab, bevacizumab biosimilar, bivatuzumab, blinatumomab, brentuximab, cantuzumab, catumaxomab, CC49, cetuximab, citatuzumab, cixutumumab, clivatuzumab, conatumumab, dacetuzumab, dalotuzumab, daratumumab, detumomab, dinutuximab, drozitumab, duligotumab, dusigituma
  • the exemplified therapeutic antibodies may be further labeled or combined with a radioisotope particle such as indium-i l l, yttrium-90 (90Y-clivatuzumab), or iodine- 131.
  • a radioisotope particle such as indium-i l l, yttrium-90 (90Y-clivatuzumab), or iodine- 131.
  • the immunotherapeutic agent is an antibody-drug conjugate (ADC).
  • ADCs that can be co-administered include without limitation drug-conjugated antibodies, fragments thereof, or antibody mimetics targeting the proteins or antigens listed above and herein (e.g., in Table B).
  • Example ADCs that can be co-administered include without limitation gemtuzumab, brentuximab, trastuzumab, inotuzumab, glembatumumab, anetumab, mirvetuximab, depatuxizumab, rovalpituzumab, vadastuximab, labetuzumab, lifastuzumab, indusatumab, polatzumab, pinatuzumab, coltuximab, indatuximab, milatuzumab, rovalpituzumab, ABBV-011, ABBV-2029, ABBV-321, ABBV-647, MLN0264 (anti-GCC, guanylyl cyclase C), T-DM1 (trastuzumab emtansine, Kadcycla); SYD985 (anti- HER2, Duocarmycin), milatuzum
  • ADCs that can be co-administered are described, e.g., in Eambert, et al., Adv Ther (2017) 34:1015-1035 and in de Goeij, Current Opinion in Immunology (2016) 40:14-23.
  • Illustrative therapeutic agents that can be conjugated to the drug-conjugated antibodies, fragments thereof, or antibody mimetics include without limitation monomethyl auristatin E (MMAE), monomethyl auristatin F (MMAF), a calicheamicin, ansamitocin, maytansine or an analog thereof (e.g., mertansine/emtansine (DM1), ravtansine/soravtansine (DM4)), an anthracyline (e.g., doxorubicin, daunorubicin, epirubicin, idarubicin), pyrrolobenzodiazepine (PBD) DNA crosslinking agent SC-DR002 (D6.5), duocarmycin, a microtubule inhibitors (MTI) (e.g., a taxane, a vinca alkaloid, an epothilone), a pyrrolobenzodiazepine (PBD) DNA crosslinking agent SC-DR002 (D
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • a cancer gene therapy and cell therapy is further combined with a cancer gene therapy and cell therapy.
  • Cancer gene therapies and cell therapies include the insertion of a normal gene into cancer cells to replace a mutated or altered gene; genetic modification to silence a mutated gene; genetic approaches to directly kill the cancer cells; including the infusion of immune cells designed to replace most of the patient’s own immune system to enhance the immune response to cancer cells, or activate the patient’s own immune system (T cells or Natural Killer cells) to kill cancer cells, or find and kill the cancer cells; genetic approaches to modify cellular activity to further alter endogenous immune responsiveness against cancer.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • cellular therapies include without limitation co-administration of one or more of a population of immune cells.
  • the immune cells are natural killer (NK) cells, NK-T cells, T cells, gamma delta T cells, B-cells, cytokine-induced killer (CIK) cells, macrophage (MAC) cells, tumor infiltrating lymphocytes (TILs) a granulocyte, an innate lymphoid cell, a megakaryocyte, a monocyte, a macrophage, a platelet, a thymocyte, a myeloid cell, and/or dendritic cells (DCs).
  • NK natural killer
  • NK-T cells T cells
  • gamma delta T cells B-cells
  • CIK cytokine-induced killer
  • MAC macrophage
  • TILs tumor infiltrating lymphocytes
  • DCs dendritic cells
  • the cellular therapy entails a T cell therapy, e.g., co-administering a population of alpha/beta TCR T cells, gamma/delta TCR T cells, regulatory T (Treg) cells and/or TRuCTM T cells.
  • the cellular therapy entails a NK cell therapy, e.g., co-administering NK-92 cells or JK500 cells.
  • a cellular therapy can entail the co-administration of cells that are autologous, syngeneic or allogeneic to the subject.
  • the cellular therapy entails co-administering immune cells engineered to express chimeric antigen receptors (CARs) or T cell receptors (TCRs) TCRs.
  • CARs chimeric antigen receptors
  • TCRs T cell receptors
  • a population of immune cells is engineered to express a CAR, wherein the CAR comprises a tumor antigen-binding domain.
  • TCRs T cell receptors
  • a population of immune cells is engineered to express T cell receptors (TCRs) engineered to target tumor derived peptides presented on the surface of tumor cells.
  • the immune cell engineered to express chimeric antigen receptors (CARs) or T cell receptors (TCRs) TCRs is a T cell.
  • the immune cell engineered to express chimeric antigen receptors (CARs) or T cell receptors (TCRs) TCRs is an NK cell.
  • the CAR comprises an antigen binding domain, a transmembrane domain, and an intracellular signaling domain.
  • the intracellular domain comprises a primary signaling domain, a costimulatory domain, or both of a primary signaling domain and a costimulatory domain.
  • the primary signaling domain comprises a functional signaling domain of one or more proteins selected from CD3 zeta, CD3 gamma, CD3 delta, CD3 epsilon, common FcR gamma (FCERIG), FcR beta (Fc Epsilon Rib), CD79a, CD79b, Fcgamma Rlla, DAP10, and DAP12 4-1BB/CD137, activating NK cell receptors, an Immunoglobulin protein, B7-H3, BAFFR, BLAME (SLAMF8), BTLA, CD100 (SEMA4D), CD103, CD160 (BY55), CD18, CD19, CD19a, CD2, CD247, CD27, CD276 (B7-H3), CD28, CD29, CD3 delta, CD3 epsilon, CD3 gamma, CD30, CD4, CD40, CD49a, CD49D, CD49f, CD69, CD7, CD84, CD8alpha,
  • the costimulatory domain comprises a functional domain of one or more proteins selected from CD27, CD28, 4-lBB(CD137), 0X40, CD30, CD40, PD- 1, ICOS, CD2, CD7, LIGHT, NKG2C, lymphocyte function-associated antigen-1 (LFA-1), MYD88, B7-H3, a ligand that specifically binds with CD83, CDS, ICAM-1, GITR, BAFFR, HVEM (LIGHTR), SLAMF7, NKp80 (KLRFI), CD19, CD4, CD8alpha, CD8beta, IL2R beta, IL2R gamma, IL7R alpha, ITGA4, VLA1, CD49a, ITGA4, IA4, CD49D, ITGA6, VLA-6, CD49f, ITGAD, ITGAE, CD103, ITGAL, CD1A (NCBI Gene ID: 909), CD1B (NCBI Gene ID: 910), CD2, CD7, LIGHT, N
  • the transmembrane domain comprises a transmembrane domain derived from a protein selected from the alpha, beta or zeta chain of the T-cell receptor, CD28, CD3 epsilon, CD3 delta, CD3 gamma, CD45, CD4, CD5, CD7, CD8 alpha, CD8 beta, CD9, CDlla, CDllb, CDllc, CDlld, CD16, CD18, CD22, CD33, CD37, CD64, CD80, CD86, CD134, CD137, CD154, KIRDS2, 0X40, CD2, CD27, ICOS (CD278), 4-lBB(CD137), GITR, CD40, BAFFR, HVEM (LIGHTR), SLAMF7, NKp80 (KLRF1), CD19, CD19a, IL2R beta, IL2R gamma, IL7R alpha, ITGA1, VLA1, CD49a, ITGA4, IA4, CD49
  • the CAR comprises a hinge domain.
  • a hinge domain may be derived from a protein selected from the CD2, CD3 delta, CD3 epsilon, CD3 gamma, CD4, CD7, CD8. alpha., CD8.beta., CDlla (ITGAL), CDllb (ITGAM), CDllc (ITGAX), CDlld (ITGAD), CD18 (ITGB2), CD19 (B4), CD27 (TNFRSF7), CD28, CD28T, CD29 (ITGB1), CD30 (TNFRSF8), CD40 (TNFRSF5), CD48 (SLAMF2), CD49a (ITGA1), CD49d (ITGA4), CD49f (ITGA6), CD66a (CEACAM1), CD66b (CEACAM8), CD66c (CEACAM6), CD66d (CEACAM3), CD66e (CEACAM5), CD69 (CLEC2), CD79A (B-cell antigen receptor complex- associated alpha., CD8.
  • the TCR or CAR antigen binding domain or the immunotherapeutic agent described herein binds a tumor-associated antigen (TAA).
  • TAA tumor-associated antigen
  • the tumor-associated antigen is selected from: CD19; CD123; CD22; CD30; CD171; CS-1 (also referred to as CD2 subset 1, CRACC, SLAMF7, CD319, and 19A24); C-type lectin-like molecule- 1 (CLL-1 or CLECLI); CD33; epidermal growth factor receptor variant III (EGFRvlll); ganglioside G2 (GD2); ganglioside GD3 (aNeuSAc(2- 8)aNeuSAc(2-3)PDGaip(l-4)bDGIcp(l-l)Cer); ganglioside GM3 (aNeuSAc(2-3)PDGalp(l- 4)PDGlcp(l-l)Cer); GM-CSF receptor; TNF receptor superfamily member 17 (TNFRSF17, BCMA); B-lymphocyte cell adhesion molecule; Tn antigen ((Tn Ag) or (GalNAcu-Ser/Thr));
  • the tumor antigen is selected from CD 150, 5T4, ActRIIA, B7, TNF receptor superfamily member 17 (TNFRSF17, BCMA), CA-125, CCNA1, CD123, CD126, CD138, CD14, CD148, CD15, CD19, CD20, CD200, CD21, CD22, CD23, CD24, CD25, CD26, CD261, CD262, CD30, CD33, CD362, CD37, CD38, CD4, CD40, CD40L, CD44, CD46, CD5, CD52, CD53, CD54, CD56, CD66a-d, CD74, CD8, CD80, CD92, CE7, CS- 1, CSPG4, ED-B fibronectin, EGFR, EGFRvIII, EGP-2, EGP-4, EPHa2, ErbB2, ErbB3, ErbB4, FBP, HER1-HER2 in combination, HER2-HER3 in combination, HERV-K, HIV-1 envelope glycoprotein gpl
  • Examples of cell therapies include without limitation: AMG-119, Algenpantucel- L, ALOFISEL®, Sipuleucel-T, (BPX-501) rivogenlecleucel US9089520, W02016100236, AU- 105, ACTR-087, activated allogeneic natural killer cells CNDO-109-AANK, MG-4101, AU- 101, BPX-601, FATE-NK100, LFU-835 hematopoietic stem cells, Imilecleucel-T, baltaleucel- T, PNK-007, UCARTCS1, ET-1504, ET-1501, ET-1502, ET-190, CD19-ARTEMIS, ProHema, FT-1050-treated bone marrow stem cell therapy, CD4CARNK-92 cells, SNK-01, NEXI-001, CryoStim, AlloStim, lentiviral transduced huCART-meso cells, CART-22 cells, EGFRt/19
  • Additional agents for targeting tumors include without limitation: Alphafetoprotein modulators, such as ET-1402, and AFP-TCR; Anthrax toxin receptor 1 modulator, such as anti-TEM8 CAR T-cell therapy; TNF receptor superfamily member 17 (TNFRSF17, BCMA), such as bb-2121 (ide-cel), bb-21217, JCARH125, UCART-BCMA, ET-140, MCM- 998, LCAR-B38M, CART-BCMA, SEA-BCMA, BB212, ET-140, P-BCMA-101, AUTO-2 (APRIL-CAR), JNJ-68284528; Anti-CLL-1 antibodies, (see, for example, PCT/US2017/025573); Anti-PD-Ll-CAR tank cell therapy, such as KD-045; Anti-PD-Ll t- haNK, such as PD-L1 t-haNK; anti-CD45 antibodies, such as 131LBC8 (lo
  • SLAM family member 7 modulator BCMA-CS 1 cCAR; autologous dendritic cell tumor antigen (ADCTA), such as ADCTA-SSLG; B-lymphocyte antigen CD20, such as ACTR707 ATTCK- 20, PBCAR-20A; allogenic T cells expressing CD20 CAR, such as LB-1905; B-lymphocyte antigen CD 19/B -lymphocyte antigen 22, such as TC-310; B-lymphocyte antigen 22 cell adhesion, such as UCART-22, JCAR-018 W02016090190; NY-ESO-1 modulators, such as GSK-3377794, TBL1301, GSK3537142; Carbonic anhydrase, such as DC-Ad-GMCAIX; Caspase 9 suicide gene, such as CaspaCIDe DLI, BPX-501; CCR5, such as SB-728; CCR5 gene inhibitor/TAT gene/TRIM5 gene stimulator, such as lentivirus vector CCR5 sh
  • Mesothelin such as CSG-MESO, TC-210; Mucin 1 modulator, such as ICTCAR-052, Tn MUC- 1 CAR-T, ICTCAR-053; Anti-MICA/MICB, such as CYAD-02; NKG2D, such as NKR-2; Ntrkrl tyrosine kinase receptor, such as JCAR-024; PRAMET cell receptor, such as BPX-701; Prostate stem cell antigen modulator, such as MB -105; Roundabout homolog 1 modulator, such as ATCG-427; Peptidoglycan recognition protein modulator, such as Tag-7 gene modified autologous tumor cell vaccine; PSMA, such as PSMA-CAR T-cell therapy (lentiviral vector, castrate-resistant prostate cancer); SLAM family member 7 modulator, such as IC9-Luc90- CD828Z; TGF beta receptor modulator, such as DNR.NPC T-cells; T-lymphocyte, such
  • MCL1 apoptosis regulator
  • an anti-CD47 agent or an anti-SIRPa agent as described herein is combined with an inhibitor of MCL1 apoptosis regulator, BCL2 family member (MCL1, TM; EAT; MCL1L; MCL1S; Mcl-1; BCL2L3; MCL1-ES; bcl2-L-3; mcll/EAT; NCBI Gene ID: 4170).
  • MCL1 apoptosis regulator BCL2 family member
  • MCL1 inhibitors examples include AMG-176, AMG-397, S-64315, and AZD-5991, 483-LM, A-1210477, UMI-77, JKY-5-037, and those described in WO2018183418, WO20 16033486, WO2019222112 and WO2017147410.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • an inhibitor of cytokine inducible SH2 containing protein CISH; CIS; G18; SOCS; CIS-1; BACTS2; NCBI Gene ID: 1154
  • CISH inhibitors include those described in W02017100861, WO2018075664 and W02019213610.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • Illustrative gene editing system that can be coadministered include without limitation a CRISPR/Cas9 system, a zinc finger nuclease system, a TALEN system, a homing endonucleases system (e.g., an ARCUS), and a homing meganuclease system.
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, is further combined with human immunoglobulin (10% liquid formulation), Cuvitru (human immunoglobulin (20% solution), levofolinate disodium, IMSA-101, BMS-986288, IMUNO BGC Moreau RJ, R-OKY-034F, GP-2250, AR-23, calcium levofolinate, porfimer sodium, RG6160, ABBV-155, CC-99282, polifeprosan 20 with carmustine, Veregen, gadoxetate disodium, gadobutrol, gadoterate meglumine, gadoteridol, 99mTc-sestamibi, pomalidomide, pacibanil, and/or valrubicin.
  • human immunoglobulin (10% liquid formulation) Cu
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • Therapeutic agents used to treat breast cancer include albumin-bound paclitaxel, anastrozole, atezolizumab, capecitabine, carboplatin, cisplatin, cyclophosphamide, docetaxel, doxorubicin, epirubicin, everolimus, exemestane, fluorouracil, fulvestrant, gemcitabine, Ixabepilone, lapatinib, letrozole, methotrexate, mitoxantrone, paclitaxel, pegylated liposomal doxorubicin, pertuzumab, tamoxifen, toremifene, trastuzumab, vinorelbine, and any combinations thereof.
  • therapeutic agents used to treat breast cancer include trastuzumab (HERCEPTIN®), pertuzumab (PERJETA®), docetaxel, carboplatin, palbociclib (IB RANCE®), letrozole, trastuzumab emtansine (KADCYLA®), fulvestrant (FASLODEX®), olaparib (LYNPARZA®), eribulin, tucatinib, capecitabine, lapatinib, everolimus (AFINITOR®), exemestane, eribulin mesylate (HALAVEN®), and combinations thereof.
  • therapeutic agents used to treat breast cancer include trastuzumab + pertuzumab + docetaxel, trastuzumab + pertuzumab + docetaxel + carboplatin, palbociclib + letrozole, tucatinib + capecitabine, lapatinib + capecitabine, palbociclib + fulvestrant, or everolimus + exemestane.
  • therapeutic agents used to treat breast cancer include trastuzumab deruxtecan (ENHERTU®), datopotamab deruxtecan (DS-1062), enfortumab vedotin (PADCEV®), balixafortide, elacestrant, or a combination thereof.
  • therapeutic agents used to treat breast cancer include balixafortide + eribulin.
  • TNBC Triple Negative Breast Cancer
  • Therapeutic agents used to treat TNBC include atezolizumab, cyclophosphamide, docetaxel, doxorubicin, epirubicin, fluorouracil, paclitaxel, and combinations thereof.
  • therapeutic agents used to treat TNBC include olaparib (LYNPARZA®), atezolizumab (TECENTRIQ®), paclitaxel or nab-paclitaxel (ABRAXANE®), eribulin, bevacizumab (AVASTIN®), carboplatin, gemcitabine, eribulin mesylate (HALAVEN®), pembrolizumab (KEYTRUDA®), cisplatin, doxorubicin, epirubicin, or a combination thereof.
  • therapeutic agents to treat TNBC include atezolizumab + paclitaxel, bevacizumab + paclitaxel, carboplatin + paclitaxel, carboplatin + gemcitabine, or paclitaxel + gemcitabine.
  • therapeutic agents used to treat TNBC include eryaspase, capivasertib, alpelisib, rucaparib + nivolumab, atezolumab + paclitaxel + gemcitabine+ capecitabine + carboplatin, ipatasertib + paclitaxel, ladiratuzumab vedotin + pembrolimab, durvalumab + DS-8201a, trilaciclib + gemcitabine +carboplatin.
  • therapeutic agents used to treat TNBC include trastuzumab deruxtecan (ENHERTU®), datopotamab deruxtecan (DS- 1062), enfortumab vedotin (PADCEV®), balixafortide, adagloxad simolenin, nelipepimut-s (NEUVAX®), nivolumab (OPDIVO®), rucaparib, toripalimab (TUOYI®), camrelizumab, capivasertib, durvalumab (IMFINZI®), and combinations thereof.
  • ENHERTU® trastuzumab deruxtecan
  • DS- 1062 datopotamab deruxtecan
  • PADCEV® enfortumab vedotin
  • balixafortide adagloxad simolenin
  • NEUVAX® nelipepimut-s
  • OPDIVO®
  • therapeutic agents use to treat TNBC include nivolumab + rucaparib, bevacizumab (AVASTIN®) + chemotherapy, toripalimab + paclitaxel, toripalimab + albuminbound paclitaxel, camrelizumab + chemotherapy, pembrolizumab + chemotherapy, balixafortide + eribulin, durvalumab + trastuzumab deruxtecan, durvalumab + paclitaxel, or capivasertib + paclitaxel.
  • AVASTIN® bevacizumab
  • Therapeutic agents used to treat bladder cancer include datopotamab deruxtecan (DS- 1062), trastuzumab deruxtecan (ENHERTU®), erdafitinib, eganelisib, lenvatinib, bempegaldesleukin (NKTR-214), or a combination thereof.
  • therapeutic agents used to treat bladder cancer include eganelisib + nivolumab, pembrolizumab (KEYTRUDA®) + enfortumab vedotin (PADCEV®), nivolumab + ipilimumab, duravalumab + tremelimumab, lenvatinib + pembrolizumab, enfortumab vedotin (PADCEV®) + pembrolizumab, and bempegaldesleukin + nivolumab.
  • PDCEV® enfortumab vedotin
  • Therapeutic agents used to treat CRC include bevacizumab, capecitabine, cetuximab, fluorouracil, irinotecan, leucovorin, oxaliplatin, panitumumab, ziv-aflibercept, and any combinations thereof.
  • therapeutic agents used to treat CRC include bevacizumab (AVASTIN®), leucovorin, 5-FU, oxaliplatin (FOLFOX), pembrolizumab (KEYTRUDA®), FOLFIRI, regorafenib (STIVARGA®), aflibercept (ZALTRAP®), cetuximab (ERBITUX®), Lonsurf (ORCANTAS®), XELOX, FOLFOXIRI, or a combination thereof.
  • AVASTIN® AVASTIN®
  • leucovorin 5-FU
  • FOLFOX pembrolizumab
  • KEYTRUDA® pembrolizumab
  • FOLFIRI FOLFIRI
  • regorafenib afenib
  • ZALTRAP® aflibercept
  • cetuximab ERBITUX®
  • Lonsurf ORCANTAS®
  • XELOX FOLFOXIRI
  • therapeutic agents used to treat CRC include bevacizumab + leucovorin + 5- FU + oxaliplatin (FOLFOX), bevacizumab + FOLFIRI, bevacizumab + FOLFOX, aflibercept + FOLFIRI, cetuximab + FOLFIRI, bevacizumab + XELOX, and bevacizumab + FOLFOXIRI.
  • FOLFOX leucovorin + 5- FU + oxaliplatin
  • therapeutic agents used to treat CRC include binimetinib + encorafenib + cetuximab, trametinib + dabrafenib + panitumumab, trastuzumab + pertuzumab, napabucasin + FOLFIRI + bevacizumab, nivolumab + ipilimumab.
  • Therapeutic agents used to treat esophageal and esophagogastric junction cancer include capecitabine, carboplatin, cisplatin, docetaxel, epirubicin, fluoropyrimidine, fluorouracil, irinotecan, leucovorin, oxaliplatin, paclitaxel, ramucirumab, trastuzumab, and any combinations thereof.
  • therapeutic agents used to treat gastroesophageal junction cancer include herceptin, cisplatin, 5-FU, ramicurimab, or paclitaxel.
  • therapeutic agents used to treat GEJ cancer include ALX-148, AO-176, or IBI-188.
  • Therapeutic agents used to treat gastric cancer include capecitabine, carboplatin, cisplatin, docetaxel, epirubicin, fluoropyrimidine, fluorouracil, Irinotecan, leucovorin, mitomycin, oxaliplatin, paclitaxel, ramucirumab, trastuzumab, and any combinations thereof.
  • Therapeutic agents used to treat head & neck cancer include afatinib, bleomycin, capecitabine, carboplatin, cetuximab, cisplatin, docetaxel, fluorouracil, gemcitabine, hydroxyurea, methotrexate, nivolumab, paclitaxel, pembrolizumab, vinorelbine, and any combinations thereof.
  • Therapeutic agents used to treat head and neck squamous cell carcinoma include pembrolizumab, carboplatin, 5-FU, docetaxel, cetuximab (Erbitux®), cisplatin, nivolumab (OPDIVO®), and combinations thereof.
  • therapeutic agents used to treat HNSCC include pembrolizumab + carboplatin + 5-FU, cetuximab + cisplatin + 5-FU, cetuximab + carboplatin + 5-FU, cisplatin + 5-FU, and carboplatin + 5-FU.
  • therapeutic agents used to treat HNSCC include durvalumab, durvalumab + tremelimumab, nivolumab + ipilimumab, rovaluecel, pembrolizumab, pembrolizumab + epacadostat, GSK3359609 + pembrolizumab, lenvatinib + pembrolizumab, retifanlimab, retifanlimab + enobituzumab, ADU-S100 + pembrolizumab, epacadostat + nivolumab+ ipilimumab/lirilumab .
  • Therapeutic agents used to treat non-small cell lung cancer include afatinib, albumin-bound paclitaxel, alectinib, atezolizumab, bevacizumab, bevacizumab, cabozantinib, carboplatin, cisplatin, crizotinib, dabrafenib, docetaxel, erlotinib, etoposide, gemcitabine, nivolumab, paclitaxel, pembrolizumab, pemetrexed, ramucirumab, trametinib, trastuzumab, vandetanib, vemurafenib, vinblastine, vinorelbine, and any combinations thereof.
  • NSCLC non-small cell lung cancer
  • therapeutic agents used to treat NSCLC include alectinib (ALECENSA®), dabrafenib (TAFINLAR®), trametinib (MEKINIST®), osimertinib (TAGRISSO®), entrectinib (TARCEVA®), crizotinib (XALKORI®), pembrolizumab (KEYTRUDA®), carboplatin, pemetrexed (ALIMTA®), nab-paclitaxel (ABRAXANE®), ramucirumab (CYRAMZA®), docetaxel, bevacizumab (AVASTIN®), brigatinib, gemcitabine, cisplatin, afatinib (GILOTRIF®), nivolumab (OPDIVO®), gefitinib (IRESSA®), and combinations thereof.
  • ALECENSA® alectinib
  • dabrafenib TAFINLAR®
  • therapeutic agents used to treat NSCLC include dabrafenib + trametinib, pembrolizumab + carboplatin + pemetrexed, pembrolizumab + carboplatin + nab-paclitaxel, ramucirumab + docetaxel, bevacizumab + carboplatin + pemetrexed, pembrolizumab + pemetrexed + carboplatin, cisplatin + pemetrexed, bevacizumab + carboplatin + nab-paclitaxel, cisplatin + gemcitabine, nivolumab + docetaxel, carboplatin + pemetrexed, carboplatin + nab-paclitaxel, or pemetrexed + cisplatin + carboplatin.
  • therapeutic agents used to NSCLC include datopotamab deruxtecan (DS- 1062), trastuzumab deruxtecan (ENHERTU®), enfortumab vedotin (PADCEV®), durvalumab, canakinumab, cemiplimab, nogapendekin alfa, avelumab, tiragolumab, domvanalimab, vibostolimab, ociperlimab, or a combination thereof.
  • DS- 1062 datopotamab deruxtecan
  • ENHERTU® trastuzumab deruxtecan
  • PADCEV® enfortumab vedotin
  • durvalumab canakinumab
  • cemiplimab nogapendekin alfa
  • avelumab avelumab
  • tiragolumab domvanalimab
  • vibostolimab vibost
  • therapeutic agents used to treat NSCLC include datopotamab deruxtecan + pembrolizumab, datopotamab deruxtecan + durvalumab, durvalumab + tremelimumab, pembrolizumab + lenvatinib + pemetrexed, pembrolizumab + olaparib, nogapendekin alfa (N-803) + pembrolizumab, tiragolumab + atezolizumab, vibostolimab + pembrolizumab, or ociperlimab + tislelizumab.
  • Therapeutic agents used to treat small cell lung cancer include atezolizumab, bendamustime, carboplatin, cisplatin, cyclophosphamide, docetaxel, doxorubicin, etoposide, gemcitabine, ipillimumab, irinotecan, nivolumab, paclitaxel, temozolomide, topotecan, vincristine, vinorelbine, and any combinations thereof.
  • therapeutic agents used to treat SCLC include atezolizumab, carboplatin, cisplatin, etoposide, paclitaxel, topotecan, nivolumab, durvalumab, trilaciclib, or combinations thereof.
  • therapeutic agents used to treat SCLC include atezolizumab + carboplatin + etoposide, atezolizumab + carboplatin, atezolizumab + etoposide, or carboplatin + paclitaxel.
  • Therapeutic agents used to treat ovarian cancer include 5-flourouracil, albumin bound paclitaxel, altretamine, anastrozole, bevacizumab, capecitabine, carboplatin, cisplatin, cyclophosphamide, docetaxel, doxorubicin, etoposide, exemestane, gemcitabine, ifosfamide, irinotecan, letrozole, leuprolide acetate, liposomal doxorubicin, megestrol acetate, melphalan, olaparib, oxaliplatin, paclitaxel, pazopanib, pemetrexed, tamoxifen, topotecan, vinorelbine, and any combinations thereof.
  • Therapeutic agents used to treat pancreatic cancer include 5-FU, leucovorin, oxaliplatin, irinotecan, gemcitabine, nab-paclitaxel (ABRAXANE®), FOLFIRINOX, and combinations thereof.
  • therapeutic agents used to treat pancreatic cancer include 5-FU + leucovorin + oxaliplatin + irinotecan, 5-FU + nanoliposomal irinotecan, leucovorin + nanoliposomal irinotecan, and gemcitabine + nab-paclitaxel.
  • Therapeutic agents used to treat prostate cancer include enzalutamide
  • therapeutic agents used to treat prostate cancer include enzalutamide + leuprolide, trifluridine + tipiracil (LONSURF®), cabazitaxel + prednisone, abiraterone + prednisone, docetaxel + prednisone, mitoxantrone + prednisone, bicalutamide + LHRH, flutamide + LHRH, leuprolide + flutamide , and abiraterone + prednisone + ADT.
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein are co-administered with one or more therapeutic agents selected from a PI3K inhibitor, a FLT3R agonist, a PD-1 antagonist, a PD-L1 antagonist, an MCL1 inhibitor, a CCR8 binding agent, an HPK1 antagonist, a DGKa inhibitor, a CISH inhibitor, a PARP-7 inhibitor, a Cbl-b inhibitor, a KRAS inhibitor (e.g., a KRAS G12C or G12D inhibitor), a KRAS degrader, a beta- catenin degrader, a helios degrader, a CD73 inhibitor, an adenosine receptor antagonist, a TIGIT antagonist, a TREM1 binding agent, a TREM
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, are co-administered with one or more therapeutic agents selected from a PI3K6 inhibitor (e.g., idealisib), a FLT3L-Fc fusion protein (e.g., GS-3583), an anti-PD-1 antibody (pembrolizumab, nivolumab, zimberelimab), a small molecule PD-L1 inhibitor (e.g., GS-4224), an anti-PD-Ll antibody (e.g., atezolizumab, avelumab), a small molecule MCL1 inhibitor (e.g., GS-9716), a small molecule HPK1 inhibitor (e.g., GS-6451), a HPK1 degrader (
  • the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and the anti-Trop-2 ADC (e.g., sacituzumab govitecan), as described herein, are co-administered with one or more therapeutic agents selected from idealisib, GS-3583, zimberelimab, GS-4224, GS-9716, GS-6451, quemliclustat (AB680), etrumadenant (AB928), domvanalimab, AB3O8, PY159, PY314, AGEN-1223, AGEN-2373, axicabtagene ciloleucel and brexucabtagene autoleucel.
  • one or more therapeutic agents selected from idealisib, GS-3583, zimberelimab, GS-4224, GS-9716, GS-6451, quemliclustat (AB680), etrumadenant (AB928), dom
  • compositions e.g., a therapeutically effective dose of an agent that inhibits binding between CD47 and SIRPa and a therapeutically effective dose of an anti-Trop-2 ADC.
  • compositions are administered to a patient in an amount sufficient to substantially ablate targeted cells, as described above.
  • An amount adequate to accomplish this is defined as a “therapeutically effective dose,” which may provide for an improvement in overall survival rates.
  • the term “therapeutically effective amount” is an amount that is effective to ameliorate a symptom of a disease (e.g., a cancer as described herein).
  • a therapeutically effective amount can be a “prophylactically effective amount” as prophylaxis can be considered therapy.
  • Single or multiple administrations of the compositions may be administered depending on the dosage and frequency as needed and tolerated by the patient. The particular dose used for a treatment will depend upon the medical condition and history of the mammal, as well as other factors such as age, weight, gender, administration route, efficiency, etc.
  • combined therapeutic amounts of an agent that inhibits binding between CD47 and SIRPa; and an anti-Trop-2 ADC, as described herein, optionally, with one or more additional therapeutic agents, as described herein can (i) reduce the number of diseased cells; (ii) reduce tumor size; (iii) inhibit, retard, slow to some extent, and preferably stop the diseased cell infiltration into peripheral organs; (iv) inhibit (e.g., slow to some extent and preferably stop) tumor metastasis; (v) inhibit tumor growth; (vi) prevent or delay occurrence and/or recurrence of a tumor; and/or (vii) relieve to some extent one or more of the symptoms associated with cancer or myeloproliferative disease.
  • combined therapeutic amounts of an agent that inhibits binding between CD47 and SIRPa; and an anti- Trop-2 ADC, as described herein, optionally, with one or more additional therapeutic agents, as described herein can (i) reduce the number of cancer cells; (ii) reduce tumor size; (iii) inhibit, retard, slow to some extent, and preferably stop cancer cell infiltration into peripheral organs; (iv) inhibit (e.g., slow to some extent and preferably stop) tumor metastasis; (v) inhibit tumor growth; (vi) prevent or delay occurrence and/or recurrence of a tumor; and/or (vii) relieve to some extent one or more of the symptoms associated with the cancer.
  • the amount is sufficient to ameliorate, palliate, lessen, and/or delay one or more of symptoms of cancer.
  • An “increased” or “enhanced” amount refers to an increase that is 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2, 2.5, 3, 3.5, 4, 4.5, 5, 6, 7, 8, 9, 10, 15, 20, 30, 40, or 50 or more times (e.g., 100, 500, 1000 times) (including all integers and decimal points in between and above 1, e.g., 2.1, 2.2, 2.3, 2.4, etc.) an amount or level described herein.
  • It may also include an increase of at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 100%, at least 150%, at least 200%, at least 500%, or at least 1000% of an amount or level described herein.
  • a “decreased” or “reduced” or “lesser” amount refers to a decrease that is about 1.1, 1.2, 1.3, 1.4, 1.5, 1.6 1.7, 1.8, 1.9, 2, 2.5, 3, 3.5, 4, 4.5, 5, 6, 7, 8, 9, 10, 15, 20, 30, 40, or 50 or more times (e.g., 100, 500, 1000 times) (including all integers and decimal points in between and above 1, e.g., 1.5, 1.6, 1.7, 1.8, etc.) an amount or level described herein.
  • tumor burden is determined using linear dimensional methods (e.g. Response Evaluation Criteria in Solid Tumors (RECIST) vl.l (Eisenhauer, et al., E r J Cancer. (2009) 45(2):228-47).
  • tumor burden is determined using volumetric analysis (e.g., positron emission tomography (PET) / computed tomography (CT) scan).
  • an “anti-tumor effect” as used herein refers to a biological effect that can present as a decrease in tumor volume, a decrease in the number of tumor cells, a decrease in tumor cell proliferation, a decrease in the number of metastases, an increase in overall or progression-free survival, an increase in life expectancy, or amelioration of various physiological symptoms associated with the tumor.
  • An anti-tumor effect can also refer to the prevention of the occurrence or recurrence of a tumor, e.g., a relapse after remission.
  • Effective doses of the combined agents for the treatment of cancer vary depending upon many different factors, including means of administration, target site, physiological state of the patient, whether the patient is human or an animal, other medications administered, and whether treatment is prophylactic or therapeutic.
  • the patient is a human, but nonhuman mammals may also be treated, e.g., companion animals such as dogs, cats, horses, etc., laboratory mammals such as non-human primates, rabbits, mice, rats, etc., and the like. Treatment dosages can be titrated to optimize safety and efficacy.
  • a therapeutically effective dose of an anti-CD47 antibody can depend on the specific agent used, but is usually about 10 mg/kg body weight or more (e.g., about 10 mg/kg or more, about 15 mg/kg or more, 20 mg/kg or more, about 25 mg/kg or more, about 30 mg/kg or more, about 35 mg/kg or more, about 40 mg/kg or more, about 45 mg/kg or more, about 50 mg/kg or more, or about 55 mg/kg or more, or about 60 mg/kg or more, or about 65 mg/kg or more, or about 70 mg/kg or more), or from about 10 mg/kg, from about 15 mg/kg to about 70 mg/kg (e.g., from about 10 mg/kg to about 67.5 mg/kg, or from about 10 mg/kg, from about 15 mg/kg to about 60 mg/kg).
  • about 10 mg/kg body weight or more e.g., about 10 mg/kg or more, about 15 mg/kg or more, 20 mg/kg or more, about 25 mg/kg or more,
  • the therapeutically effective dose of the anti-CD47 antibody is 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, or 67.5 mg/kg. In some embodiments, the therapeutically effective dose of the anti-CD47 antibody is 10 to 60 mg/kg. In some embodiments, the therapeutically effective dose of the anti-CD47 antibody is 10 to 67.5 mg/kg. In some embodiments, the anti-CD47 antibody is administered at a dose of at least 10-30, 20-30, 15-60, 30-60, 10, 15, 20, 30, 40, 45, 50, or 60 mg of antibody per kg of body weight.
  • a therapeutic dose of an anti-CD47 antibody can be a flat dose.
  • a flat dose can be given irrespective of a particular subject’s weight.
  • a flat dose can be given based on a particular subject’s weight falling within a particular weight range, e.g., a first range of less than or equal to 100 kg; or a second range of greater than 100 kg.
  • a flat dose can be, e.g., 1000-5000, 2000-4000, 2000-3500, 2400-3500, 1000, 1100, 1200, 1300, 1400, 1500, 1600, 1700, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2600, 2700, 2800, 2900, 3000, 3100, 3200, 3300, 3400, 3500, 3600, 3700, 3800, 3900, 4000, 4100, 4200, 4300, 4400, 4500, 4600, 4700, 4800, 4900, 5000 mg, or an interim number of mg thereof.
  • Methods can include a step of administering a primer agent to subject, followed by a step of administering a therapeutically effective dose of an anti-CD47 to the subject.
  • the step of administering a therapeutically effective dose is performed after at least about 3 days (e.g., at least about 4 days, at least about 5 days, at least about 6 days, at least about 7 days, at least about 8 days, at least about 9 days, or at least about 10 days) after beginning the administration of a primer agent. This period of time is, for example, sufficient to provide for enhanced reticulocyte production by the individual.
  • the anti- CD47 agent is an isolated anti-CD47 antibody.
  • a therapeutically effective dose of an anti-CD47 can be achieved in a number of different ways. In some cases, two or more therapeutically effective doses are administered after a primer agent is administered. Suitable administration of a therapeutically effective dose can entail administration of a single dose, or can entail administration of doses daily, semi-weekly, weekly, once every two weeks, once a month, annually, etc.
  • a therapeutically effective dose is administered as two or more doses of escalating concentration (z.e., increasing doses), where (i) all of the doses are therapeutic doses, or where (ii) a sub-therapeutic dose (or two or more sub-therapeutic doses) is initially given and therapeutic doses are achieved by said escalation.
  • a therapeutically effective dose can be administered weekly, beginning with a sub-therapeutic dose (e.g., a dose of less than 10 mg/kg, e.g., 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kg or 1 mg/kg), and each subsequent dose can be increased by a particular increment (e.g., by 5 mg/kg, by 10 mg/kg, by 15 mg/kg), or by variable increments, until a therapeutic dose (e.g., 15 mg/kg, 30 mg/kg, 45 mg/kg, 60 mg/kg) is reached, at which point administration may cease or may continue with one or more additional therapeutic doses (e.g., continued therapeutic doses or escalated therapeutic doses, e.g., doses of 15 mg/kg, 30 mg/kg, 45 mg/kg, 60 mg/kg).
  • a sub-therapeutic dose e.g., a dose of less than 10 mg/kg, e.g., 5 mg/kg, 4 mg/kg, 3 mg/kg,
  • a therapeutically effective dose can be administered weekly, beginning with one or more relatively lower therapeutic doses (e.g., a dose of 10 mg/kg, 15 mg/kg or 30 mg/kg), and each subsequent dose can be increased by a particular increment (e.g., by 10 mg/kg or 15 mg/kg), or by variable increments, until a relatively higher therapeutic dose (e.g., 30 mg/kg, 45 mg/kg, 60 mg/kg, 100 mg/kg, etc.) is reached, at which point administration may cease or may continue (e.g., one or more continued or escalated therapeutic doses, e.g., doses of 30 mg/kg, 45 mg/kg, 60 mg/kg, 100 mg/kg, etc.).
  • a relatively lower therapeutic doses e.g., a dose of 10 mg/kg, 15 mg/kg or 30 mg/kg
  • each subsequent dose can be increased by a particular increment (e.g., by 10 mg/kg or 15 mg/kg), or by variable increments, until a relatively higher therapeutic dose
  • relatively lower therapeutic doses are administered more often (e.g., two or more doses of 15 mg/kg administered weekly (Q1W) or two or more doses of 30 mg/kg administered every two weeks (Q2W)), and relatively higher therapeutic doses are administered less often (e.g., two or more doses of 45 mg/kg administered every 3 weeks (Q3W) or two or more doses of 60 mg/kg administered monthly or every 4 weeks (Q4W)).
  • administration of a therapeutically effective dose can be a continuous infusion and the dose can altered (e.g., escalated) over time.
  • the dose needed to achieve and/or maintain a particular serum level of the administered composition is proportional to the amount of time between doses and inversely proportional to the number of doses administered. Thus, as the frequency of dosing increases, the needed dose decreases.
  • An exemplary treatment regime entails administration once every two weeks or once a month or once every 3 to 6 months.
  • Therapeutic entities described herein are usually administered on multiple occasions. Intervals between single dosages can be weekly, monthly or yearly. Intervals can also be irregular as indicated by measuring blood levels of the therapeutic entity in the patient. Alternatively, therapeutic entities described herein can be administered as a sustained release formulation, in which case less frequent administration is used.
  • the interval between each single dose is a week. In some embodiments, the interval between each single dose is two weeks. In some embodiments, the interval between each single dose is three weeks. In some embodiments, the interval between each single dose is four weeks. In some embodiments, the interval between each single dose of anti-CD47 antibody is a week. In some embodiments, the interval between each single dose of anti-CD47 antibody is two weeks. In some embodiments, the interval between each single dose of anti-CD47 antibody is three weeks. In some embodiments, the interval between each single dose of anti-CD47 antibody is four weeks. In some embodiments, the interval between each single dose of magrolimab is a week. In some embodiments, the interval between each single dose of magrolimab is two weeks. In some embodiments, the interval between each single dose of magrolimab is three weeks. In some embodiments, the interval between each single dose of magrolimab is four weeks.
  • a “maintenance dose” is a dose intended to be a therapeutically effective dose.
  • multiple different maintenance doses may be administered to different subjects.
  • some of the maintenance doses may be therapeutically effective doses and others may be sub-therapeutic doses.
  • a relatively low dosage may be administered at relatively infrequent intervals over a long period of time. Some patients continue to receive treatment for the rest of their lives. In other therapeutic applications, a relatively high dosage at relatively short intervals is sometimes used until progression of the disease is reduced or terminated, and preferably until the patient shows partial or complete amelioration of symptoms of disease. Thereafter, the patent can be administered a prophylactic regime.
  • subtherapeutic dose is a dose that is not sufficient to effect the desired clinical results.
  • a subtherapeutic dose of a CD47 or SIRPa binding agent or an anti-Trop-2 ADC is an amount that is not sufficient to palliate, ameliorate, stabilize, reverse, prevent, slow or delay the progression of the disease state (e.g., a cancer, such as a Trop-2 expressing cancer, as described herein).
  • priming dose refers to a dose of an anti-CD47 antibody that primes a subject for administration of a therapeutically effective dose of anti-CD47 antibody such that the therapeutically effective dose does not result in a severe loss of RBCs (reduced hematocrit or reduced hemoglobin).
  • the specific appropriate priming dose of an anti- CD47 antibody can vary depending on the nature of the agent used and on numerous subjectspecific factors (e.g., age, weight, etc.).
  • Suitable priming doses of an anti-CD47 antibody include from about 0.5 mg/kg to about 5 mg/kg, from about 0.5 mg/kg to about 4 mg/kg, from about 0.5 mg/kg to about 3 mg/kg, from about 1 mg/kg to about 5 mg/kg, from about 1 mg/kg to about 4 mg/kg, from about 1 mg/kg to about 3 mg/kg, about 1 mg/kg, about 2 mg/kg, about 3 mg/kg, about 4 mg/kg, about 5 mg/kg.
  • the priming dose is preferably 1 mg/kg.
  • the anti-CD47 antibody is administered to the subject as a priming dose ranging from about 0.5 mg to about 10 mg, e.g., from about 0.5 to about 5 mg/kg of antibody, optionally, 4 mg/kg, 3 mg/kg, 2 mg/kg, or 1 mg/kg of antibody.
  • the anti-CD47 antibody is administered to the subject as a therapeutic dose ranging from about 20 to about 67.5 mg/kg of antibody, optionally from 15 to 60 mg/kg of antibody, optionally from 30 to 60 mg/kg of antibody, optionally 15 mg/kg of antibody, 20 mg/kg of antibody, 30 mg/kg of antibody, 45 mg/kg of antibody, 60 mg/kg of antibody, or 67.5 mg/kg of antibody.
  • a priming dose of an anti-CD47 antibody can be a flat priming dose.
  • a flat priming dose can be given irrespective of a particular subject’s weight.
  • a flat priming dose can be given based on a particular subject’s weight falling within a particular weight range, e.g., a first range of less than or equal to 100 kg; or a second range of greater than 100 kg.
  • a flat priming dose can be, e.g., 10-200, 50-100, 80-800, 80-400, 80-200, 70-90, 75-85, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, 180, 190, 200, 240, 300, 320, 400, 500, 600, 700 or 800 mg, or an interim number of mg thereof.
  • an effective priming dose of magrolimab is provided, where the effective priming dose for a human is around about 1 mg/kg, e.g., from at least about 0.5 mg/kg up to not more than about 5 mg/kg; from at least about 0.75 mg/kg up to not more than about 1.25 mg/kg; from at least about 0.95 mg/kg up to not more than about 1.05 mg/kg; and may be around about 1 mg/kg.
  • an initial dose of a CD47 or SIRPa binding agent is infused over a period of at least about 2 hours, at least about 2.5 hours, at least about 3 hours, at least about 3.5 hours, at least about 4 hours, at least about 4.5 hours, at least about 5 hours, at least about 6 hours or more.
  • an initial dose is infused over a period of time from about 2.5 hours to about 6 hours; for example, from about 3 hours to about 4 hours.
  • the dose of agent in the infusate is from about 0.05 mg/ml to about 0.5 mg/ml; for example, from about 0.1 mg/ml to about 0.25 mg/ml.
  • an initial dose of a CD47 or SIRPa binding agent is administered by continuous fusion, e.g., as an osmotic pump, delivery patch, etc., where the dose is administered over a period of at least about 6 hours, at least about 12 hours, at least about 24 hours, at least about 2 days, at least about 3 days.
  • a priming dose is administered by continuous fusion, e.g., as an osmotic pump, delivery patch, etc.
  • the dose is administered over a period of at least about 6 hours, at least about 12 hours, at least about 24 hours, at least about 2 days, at least about 3 days.
  • It also consists of a semi permeable membrane on one end through which water is drawn into the osmotic engine and establishes a large and constant osmotic gradient between the tissue water and the osmotic engine.
  • Other compartment consists of a drug solution with an orifice from which the drug is released due to the osmotic gradient. This helps to provide site specific and systemic drug delivery when implanted in humans.
  • the preferred site of implantation is subcutaneous placement in the inside of the upper arm.
  • a therapeutic dose of an anti-CD47 or anti- SIRPa agent is administered.
  • the therapeutic dose can be administered in number of different ways. In some embodiments, two or more therapeutically effective doses are administered after a primer agent is administered, e.g., in a weekly dosing schedule. In some embodiments a therapeutically effective dose of an anti-CD47 agent is administered as two or more doses of escalating concentration, in others the doses are equivalent. There is reduced hemagglutination after the priming dose.
  • a therapeutically effective dose of an anti-SIRPa antibody can depend on the specific agent used, but is usually about 10 mg or more, e.g., about 30 mg, 50 mg, 100 mg, 200 mg, 400 mg or 800 mg, or more.
  • Multiple administrations of an anti-SIRPa antibody, e.g., without Fc effector function, can be performed over an extended period of time, e.g., over 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 months, at regular intervals, e.g., every 2 weeks (Q2W), every 3 weeks (Q3W), every 4 weeks (Q4W).
  • the sacituzumab govitecan is administered at one or more doses in the range of 3 mg/kg to 18 mg/kg, e.g., 8 mg/kg to 10 mg/kg.
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 30 mg/kg, followed by administration of one or more therapeutic doses of 60 mg/kg. In some embodiments, the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 20 mg/kg, followed by administration of one or more therapeutic doses of 45 mg/kg. In some embodiments, the magrolimab is first administered at a priming dose of 1 mg/kg, then administered at one or more therapeutic doses of 15 mg/kg, followed by administration of one or more therapeutic doses of 30 mg/kg.
  • the magrolimab and the sacituzumab govitecan are administered for first, second and third 21 -day cycles, wherein: a) for the first 21 -day cycle, magrolimab is administered at a dose of 1 mg/kg on day 1 and at a dose of 30 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 or 2 and 8 (z.e., on days 1 and 8 or on days 2 and 8); b) for the second 21 -day cycle, magrolimab is administered at a dose of 30 mg/kg on days 1, 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8; and c) for the third 21 -day cycle, magrolimab is administered at a dose of 60 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10
  • the magrolimab and the sacituzumab govitecan are administered for first, second and third 21-day cycles, wherein: a) for the first 21-day cycle, magrolimab is administered at a dose of 1 mg/kg on day 1 and at a dose of 20 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 or 2 and 8 (z.e., on days 1 and 8 or on days 2 and 8); b) for the second 21-day cycle, magrolimab is administered at a dose of 20 mg/kg on days 1, 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8; and c) for the third 21-day cycle, magrolimab is administered at a dose of 45 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on
  • the magrolimab and the sacituzumab govitecan are administered for first, second and third 21-day cycles, wherein: a) for the first 21-day cycle, magrolimab is administered at a dose of 1 mg/kg on day 1 and at a dose of 15 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 or 2 and 8 (z.e., on days 1 and 8 or on days 2 and 8); b) for the second 21-day cycle, magrolimab is administered at a dose of 15 mg/kg on days 1, 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg on days 1 and 8; and c) for the third 21 -day cycle, magrolimab is administered at a dose of 30 mg/kg on days 8 and 15; and sacituzumab govitecan is administered at a dose of 10 mg/kg
  • the agent that inhibits binding between CD47 and SIRPa; and the Anti-Trop-2 ADC are administered in a combined synergistic amount.
  • a “combined synergistic amount” as used herein refers to the sum of a first amount (e.g., an amount of an agent that inhibits binding between CD47 and SIRPa) and a second amount (e.g., an amount of an anti-Trop-2 ADC) that results in a synergistic effect (/'. ⁇ ?., an effect greater than an additive effect).
  • the terms “synergy”, “synergism”, “synergistic”, “combined synergistic amount”, and “synergistic therapeutic effect” which are used herein interchangeably, refer to a measured effect of compounds administered in combination where the measured effect is greater than the sum of the individual effects of each of the compounds administered alone as a single agent.
  • a synergistic amount may be about 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87,
  • a synergistic amount may be about 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66,
  • Dosage and frequency may vary depending on the half-life of the therapeutic agent in the patient. It will be understood by one of skill in the art that such guidelines will be adjusted for the molecular weight of the active agent, e.g., in the use of antibody fragments, in the use of antibody conjugates, in the use of SIRPa reagents, in the use of soluble CD47 peptides etc.
  • the dosage may also be varied for localized administration, e.g., intranasal, inhalation, etc., or for systemic administration, e.g. intramuscular (i.m.), intraperitoneal (i.p.), intravenous (i.v.), subcutaneous (s.c.), intratumoral, intracranial, as appropriate.
  • the magrolimab is administered intravenously, e.g., through an in-line filter, e.g., through an in-line filter having a pore size of 5 pm, e.g., through an in-line filter having a pore size of 1.2 pm, e.g., through an in-line filter having a pore size of 0.45 pm, e.g., through an in- line filter having a pore size of 0.22 pm.
  • the agent that inhibits binding between CD47 and SIRPa; and the anti-Trop-2 ADC are administered concurrently.
  • the agent that inhibits binding between CD47 and SIRPa; and the anti-Trop-2 ADC are administered sequentially.
  • the agent that inhibits binding between CD47 and SIRPa may be administered within seconds, minutes, hours or days of the administration of the anti-Trop-2 ADC.
  • a unit dose of an agent that inhibits binding between CD47 and SIRPa is administered first, followed within seconds, minutes, hours or days by administration of a unit dose of an anti-Trop-2 ADC.
  • a unit dose of an anti-Trop-2 ADC is administered first, followed by administration of a unit dose of an agent that inhibits binding between CD47 and SIRPa within seconds, minutes, hours or days.
  • a unit dose of an agent that inhibits binding between CD47 and SIRPa is administered first, followed, after a period of hours (e.g., 1-12 hours, 1-24 hours, 1-36 hours, 1-48 hours, 1-60 hours, 1-72 hours), by administration of a unit dose of an anti-Trop-2 ADC.
  • a unit dose of an anti-Trop-2 ADC is administered first, followed, after a period of hours (e.g., 1-12 hours, 1-24 hours, 1-36 hours, 1-48 hours, 1-60 hours, 1-72 hours), by administration of a unit dose of an agent that inhibits binding between CD47 and SIRPa.
  • kits for treating, ameliorating, mitigating, or preventing or delaying the growth, proliferation, recurrence or metastasis of, a cancer in a subject comprising administering: (a) an agent that inhibits binding between CD47 and SIRPa; and (b) an anti-Trop- 2 ADC to the subject.
  • the subject is a human.
  • beneficial or desired clinical results may include one or more of the following: (i) decreasing one more symptoms resulting from the disease; (ii) diminishing the extent of the disease, stabilizing the disease (e.g., preventing or delaying the worsening of the disease); (iii) preventing or delaying the spread (e.g., metastasis) of the disease; (iv) preventing or delaying the occurrence or recurrence of the disease, delay or slowing the progression of the disease; (v) ameliorating the disease state, providing a remission (whether partial or total) of the disease, decreasing the dose of one or more other medications required to treat the disease; (vi) delaying the progression of the disease, increasing the quality of life, and/or (vii) prolonging survival.
  • the cancer has progressed following at least one prior anti-cancer therapy.
  • the cancer has progressed following at least one prior anticancer therapy selected from a taxane therapy (e.g., paclitaxel, nab-paclitaxel (ABRAXANE®), docetaxel and cabazitaxel), an immune checkpoint inhibitor therapy (e.g., anti-PDl antibody therapy or an anti-PD-Ll antibody therapy), a platinum coordination complex therapy (e.g., cisplatin, oxiloplatinim, and carboplatin) and enfortumab vedotin (PADCEV®) therapy.
  • a taxane therapy e.g., paclitaxel, nab-paclitaxel (ABRAXANE®), docetaxel and cabazitaxel
  • an immune checkpoint inhibitor therapy e.g., anti-PDl antibody therapy or an anti-PD-Ll antibody therapy
  • a platinum coordination complex therapy
  • the subject is treatment naive, i.e., combined administration of an agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and an anti-Trop-2 ADC (e.g., sacituzumab govitecan) is a first line cancer therapy.
  • an agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • an anti-Trop-2 ADC e.g., sacituzumab govitecan
  • prevention or “preventing” means any treatment (i.e., medication, drug, therapeutic) of a disease or condition (i.e., cancer) that causes the clinical symptoms of the disease or condition not to develop.
  • Compounds may, in some embodiments, be administered to a subject (including a human) who is at risk or has a family history of the disease or condition.
  • “Delaying” the development of a cancer means to defer, hinder, slow, retard, stabilize, and/or postpone development of the disease.
  • the delay can be of varying lengths of time, depending on the history of the disease and/or subject being treated. As is evident to one of skill in the art, a sufficient or significant delay can, in effect, encompass prevention, in that the individual does not develop the disease.
  • a method that “delays” development of cancer is a method that reduces probability of disease development in a given time frame and/or reduces the extent of the disease in a given time frame, when compared to not using the method. Such comparisons are typically based on clinical studies, using a statistically significant number of subjects.
  • Disease development can be detectable using standard methods, such as routine physical exams, blood draw, mammography, imaging, or biopsy. Development may also refer to disease progression that may be initially undetectable and includes occurrence, recurrence, and onset.
  • ameliorating refers to any therapeutically beneficial result in the treatment of a disease state, e.g., a cancer disease state, including prophylaxis, lessening in the severity or progression, remission, or cure thereof.
  • the methods described herein are directed to treating, ameliorating, mitigating, reducing, preventing or delaying the growth, proliferation, recurrence or metastasis of, a Trop-2 positive cancer or Trop-2 expressing cancer.
  • the Trop-2 positive cancer or Trop-2 expressing cancer is a solid epithelial cancer.
  • cancers amenable to treatment by combined administration of an agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and an anti-Trop-2 ADC (e.g., sacituzumab govitecan) include without limitation breast cancer (e.g., triple negative breast cancer), colorectal cancer, lung cancer, stomach cancer, urinary tract cancer, urothelial cancer, bladder cancer, renal cancer, pancreatic cancer, ovarian cancer, uterine cancer, esophageal cancer and prostatic cancer.
  • breast cancer e.g., triple negative breast cancer
  • colorectal cancer e.g., lung cancer, stomach cancer, urinary tract cancer, urothelial cancer, bladder cancer, renal cancer, pancreatic cancer, ovarian cancer, uterine cancer, esophageal cancer and prostatic cancer.
  • the subject has a solid tumor.
  • the solid tumor arises from a primary malignancy having increased CD47 cell surface expression the surface, e.g., head and neck (HNSCC), melanoma, breast, lung, ovarian, pancreatic, colon, bladder, prostate, leiomyosarcoma, glioblastoma, medulloblastoma, oligodendroglioma, glioma, lymphoma, and multiple myeloma.
  • the cancer or tumor is malignant and/or a metastatic.
  • the subject has a cancer selected from an epithelial tumor (e.g., a carcinoma, a squamous cell carcinoma, a basal cell carcinoma, a squamous intraepithelial neoplasia), a glandular tumor (e.g., an adenocarcinoma, an adenoma, an adenomyoma), a mesenchymal or soft tissue tumor (e.g., a sarcoma, a rhabdomyosarcoma, a leiomyosarcoma, a liposarcoma, a fibrosarcoma, a dermatofibrosarcoma, a neurofibrosarcoma, a fibrous histiocytoma, an angiosarcoma, an angiomyxoma, a leiomyoma, a chondroma, a chondrosarcoma, an alveolar soft-part
  • tissues containing cancerous cells whose proliferation is reduced or inhibited by combined administration of an agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and an anti-Trop-2 ADC (e.g., sacituzumab govitecan) include without limitation breast, prostate, brain, blood, bone marrow, liver, pancreas, skin, kidney, colon, ovary, lung, testicle, penis, thyroid, parathyroid, pituitary, thymus, retina, uvea, conjunctiva, spleen, head, neck, trachea, gall bladder, rectum, salivary gland, adrenal gland, throat, esophagus, lymph nodes, sweat glands, sebaceous glands, muscle, heart, and stomach.
  • an agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • an anti-Trop-2 ADC e.g., sacituzumab govitecan
  • the subject has a solid tumor in or arising from a tissue or organ selected from:
  • breast e.g., triple-negative breast cancer (negative for erb-b2 receptor tyrosine kinase 2 (ERBB2- or HER2-) / negative for estrogen receptor (ER-) / negative for progesterone receptor (PR-)
  • HR+/HER2- breast cancer e.g., triple-negative breast cancer (negative for erb-b2 receptor tyrosine kinase 2 (ERBB2- or HER2-) / negative for estrogen receptor (ER-) / negative for progesterone receptor (PR-)
  • invasive ductal carcinoma including without limitation, acinic cell carcinoma, adenoid cystic carcinoma, apocrine carcinoma, cribriform carcinoma, glycogen-rich/clear cell, inflammatory carcinoma, lipid-rich carcinoma, medullary carcinoma, metaplastic carcinoma, micropapillary carcinoma, mucinous carcinoma, neuroendocrine carcinoma, oncocytic carcinoma, papillary carcinoma, sebaceous carcinoma, secretory breast carcinoma, tubular carcinoma;
  • lung e.g., small cell carcinoma (SCLC), non-small cell lung carcinoma (NSCLC), including squamous cell carcinoma (SCC), adenocarcinoma and large cell carcinoma, carcinoids (typical or atypical), carcinosarcomas, pulmonary blastomas, giant cell carcinomas, spindle cell carcinomas, pleuropulmonary blastoma);
  • SCLC small cell carcinoma
  • NSCLC non-small cell lung carcinoma
  • SCC squamous cell carcinoma
  • carcinoids typically or atypical
  • carcinosarcomas pulmonary blastomas
  • giant cell carcinomas e.g., giant cell carcinomas, spindle cell carcinomas, pleuropulmonary blastoma
  • pleuropulmonary blastoma e.g., small cell carcinoma (SCLC), non-small cell lung carcinoma (NSCLC), including squamous cell carcinoma (SCC), adenocarcinoma and large cell carcinoma, carcinoids (typical or atypical), carcino
  • bone e.g., adamantinoma, aneurysmal bone cysts, angiosarcoma, chondroblastoma, chondroma, chondromyxoid fibroma, chondrosarcoma, chordoma, dedifferentiated chondrosarcoma, enchondroma, epithelioid hemangioendothelioma, fibrous dysplasia of the bone, giant cell tumour of bone, haemangiomas and related lesions, osteoblastoma, osteochondroma, osteosarcoma, osteoid osteoma, osteoma, periosteal chondroma, Desmoid tumor, Ewing sarcoma);
  • bone e.g., adamantinoma, aneurysmal bone cysts, angiosarcoma, chondroblastoma, chondroma, chondromyxoid fibroma, chondrosarcoma, chord
  • lips and oral cavity e.g., odontogenic ameloblastoma, oral leukoplakia, oral squamous cell carcinoma, primary oral mucosal melanoma
  • salivary glands e.g., pleomorphic salivary gland adenoma, salivary gland adenoid cystic carcinoma, salivary gland mucoepidermoid carcinoma, salivary gland Warthin's tumors
  • esophagus e.g., Barrett's esophagus, dysplasia and adenocarcinoma
  • esophagus e.g., Barrett's esophagus, dysplasia and adenocarcinoma
  • stomach e.g., gastric adenocarcinoma, primary gastric lymphoma, gastrointestinal stromal tumors (GISTs), metastatic deposits, gastric carcinoids, gastric sarcomas, neuroendocrine carcinoma, gastric primary squamous cell carcinoma, gastric adenoacanthomas), intestines and smooth muscle (e.g., intravenous leiomyomatosis), colon (e.g., colorectal adenocarcinoma), rectum, anus;
  • stomach e.g., gastric adenocarcinoma, primary gastric lymphoma, gastrointestinal stromal tumors (GISTs), metastatic deposits, gastric carcinoids, gastric sarcomas, neuroendocrine carcinoma, gastric primary squamous cell carcinoma, gastric adenoacanthomas), intestines and smooth muscle (e.g., intravenous leiomyomatosis), colon (e.g
  • pancreas e.g., serous neoplasms, including microcystic or macrocystic serous cystadenoma, solid serous cystadenoma, Von Hippel-Landau (VHL)-associated serous cystic neoplasm, serous cystadenocarcinoma; mucinous cystic neoplasms (MCN), intraductal papillary mucinous neoplasms (IPMN), intraductal oncocytic papillary neoplasms (IOPN), intraductal tubular neoplasms, cystic acinar neoplasms, including acinar cell cystadenoma, acinar cell cystadenocarcinoma, pancreatic adenocarcinoma, invasive pancreatic ductal adenocarcinomas, including tubular adenocarcinoma, adenosquamous carcinoma, colloid carcinoma, medullary carcinoma, hepat
  • gall bladder e.g., carcinoma of the gallbladder and extrahepatic bile ducts, intrahepatic cholangiocarcinoma
  • neuro-endocrine e.g., adrenal cortical carcinoma, carcinoid tumors, phaeochromocytoma, pituitary adenomas
  • neuro-endocrine e.g., adrenal cortical carcinoma, carcinoid tumors, phaeochromocytoma, pituitary adenomas
  • thyroid e.g., anaplastic (undifferentiated) carcinoma, medullary carcinoma, oncocytic tumors, papillary carcinoma, adenocarcinoma);
  • liver e.g., adenoma, combined hepatocellular and cholangiocarcinoma, fibrolamellar carcinoma, hepatoblastoma, hepatocellular carcinoma, mesenchymal, nested stromal epithelial tumor, undifferentiated carcinoma; hepatocellular carcinoma, intrahepatic cholangiocarcinoma, bile duct cystadenocarcinoma, epithelioid hemangioendothelioma, angiosarcoma, embryonal sarcoma, rhabdomyosarcoma, solitary fibrous tumor, teratoma, York sac tumor, carcinosarcoma, rhabdoid tumor);
  • kidney e.g., ALK-rearranged renal cell carcinoma, chromophobe renal cell carcinoma, clear cell renal cell carcinoma, clear cell sarcoma, metanephric adenoma, metanephric adenofibroma, mucinous tubular and spindle cell carcinoma, nephroma, nephroblastoma (Wilms tumor), papillary adenoma, papillary renal cell carcinoma, renal oncocytoma, renal cell carcinoma, succinate dehydrogenase-deficient renal cell carcinoma, collecting duct carcinoma);
  • ALK-rearranged renal cell carcinoma e.g., ALK-rearranged renal cell carcinoma, chromophobe renal cell carcinoma, clear cell renal cell carcinoma, clear cell sarcoma, metanephric adenoma, metanephric adenofibroma, mucinous tubular and spindle cell carcinoma, nephroma, nephroblastoma (Wil
  • peritoneum e.g., mesothelioma; primary peritoneal cancer
  • female sex organ tissues including ovary (e.g., choriocarcinoma, epithelial tumors, germ cell tumors, sex cord-stromal tumors), Fallopian tubes (e.g., serous adenocarcinoma, mucinous adenocarcinoma, endometrioid adenocarcinoma, clear cell adenocarcinoma, transitional cell carcinoma, squamous cell carcinoma, undifferentiated carcinoma, mullerian tumors, adenosarcoma, leiomyosarcoma, teratoma, germ cell tumors, choriocarcinoma, trophoblastic tumors), uterus (e.g., carcinoma of the cervix, endometrial polyps, endometrial hyperplasia, intraepithelial carcinoma (EIC), endometrial carcinoma (e.g., endometrioid carcinoma, serous carcinoma, clear cell carcinoma, mucinous
  • male sex organ tissues including prostate, testis (e.g., germ cell tumors, spermatocytic seminoma), penis;
  • bladder e.g., squamous cell carcinoma, urothelial carcinoma, bladder urothelial carcinoma
  • gliomas e.g., astrocytomas, including non-infiltrating, low-grade, anaplastic, glioblastomas; oligodendrogliomas, ependymomas), meningiomas, gangliogliomas
  • schwannomas neurilemmomas
  • craniopharyngiomas chordomas
  • Non-Hodgkin lymphomas NHLs
  • iNHL indolent non-Hodgkin’s lymphoma
  • refractory iNHL pituitary tumors
  • eye e.g., retinoma, retinoblastoma, ocular melanoma, posterior uveal melanoma, iris hamartoma
  • eye e.g., retinoma, retinoblastoma, ocular melanoma, posterior uveal melanoma, iris hamartoma
  • head and neck e.g., nasopharyngeal carcinoma, Endolymphatic Sac Tumor (ELST), epidermoid carcinoma, laryngeal cancers including squamous cell carcinoma (SCC) (e.g., glottic carcinoma, supraglottic carcinoma, subglottic carcinoma, transglottic carcinoma), carcinoma in situ, verrucous, spindle cell and basaloid SCC, undifferentiated carcinoma, laryngeal adenocarcinoma, adenoid cystic carcinoma, neuroendocrine carcinomas, laryngeal sarcoma), head and neck paragangliomas (e.g., carotid body, jugulotympanic, vagal);
  • SCC squamous cell carcinoma
  • glottic carcinoma e.g., supraglottic carcinoma, subglottic carcinoma, transglottic carcinoma
  • carcinoma in situ verrucous, spindle cell and basaloid SCC
  • undifferentiated carcinoma lary
  • thymus e.g., thymoma
  • heart e.g., cardiac myxoma
  • lymph e.g., lymphomas, including Hodgkin’s lymphoma, non-Hodgkin’s lymphoma (NHL), indolent non-Hodgkin’s lymphoma (iNHL), refractory iNHL, Epstein-Barr virus (EBV)- associated lymphoproliferative diseases, including B cell lymphomas and T cell lymphomas (e.g., Burkitt lymphoma; large B cell lymphoma, diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, indolent B-cell lymphoma, low grade B cell lymphoma, fibrin-associated diffuse large cell lymphoma; primary effusion lymphoma; plasmablastic lymphoma; extranodal NK/T cell lymphoma, nasal type; peripheral T cell lymphoma, cutaneous T cell lymphoma, angioimmunoblastic T cell lymphoma; follicular T cell lymphom
  • central nervous system e.g., gliomas including astrocytic tumors (e.g., pilocytic astrocytoma, pilomyxoid astrocytoma, subependymal giant cell astrocytoma, pleomorphic xanthoastrocytoma, diffuse astrocytoma, fibrillary astrocytoma, gemistocytic astrocytoma, protoplasmic astrocytoma, anaplastic astrocytoma, glioblastoma (e.g., giant cell glioblastoma, gliosarcoma, glioblastoma multiforme) and gliomatosis cerebri), oligodendroglial tumors (e.g., oligodendroglioma, anaplastic oligodendroglioma), oligoastrocytic tumors (e.g., oligoastrocytoma, an astrocy
  • neuroendocrine tissues e.g., paraganglionic system including adrenal medulla (pheochromocytomas) and extra-adrenal paraganglia ((extra-adrenal) paragangliomas);
  • skin e.g., clear cell hidradenoma, cutaneous benign fibrous histiocytomas, cylindroma, hidradenoma, melanoma (including cutaneous melanoma, mucosal melanoma), basal cell carcinoma, pilomatricoma, Spitz tumors); and
  • soft tissues e.g., aggressive angiomyxoma, alveolar rhabdomyosarcoma, alveolar soft part sarcoma, angiofibroma, angiomatoid fibrous histiocytoma, synovial sarcoma, biphasic synovial sarcoma, clear cell sarcoma, dermatofibrosarcoma protuberans, desmoid-type fibromatosis, small round cell tumor, desmoplastic small round cell tumor, elastofibroma, embryonal rhabdomyosarcoma, Ewing's tumors/primitive neurectodermal tumors (PNET), extraskeletal myxoid chondrosarcoma, extraskeletal osteosarcoma, paraspinal sarcoma, inflammatory myofibroblastic tumor, lipoblastoma, lipoma, chondroid lipoma, liposarcoma / malignant lipomatous tumors, lipo
  • kits comprising one or more unitary doses of the active agents, e.g., an agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and an anti-Trop-2 ADC (e.g., sacituzumab govitecan), and formulations thereof, as described herein, and instructions for use.
  • the agent that inhibits binding between CD47 and SIRPa and the anti-Trop-2 ADC can be in the same or different containers.
  • the kit can further contain a least one additional reagent, e.g.
  • Kits typically include a label indicating the intended use of the contents of the kit.
  • the term label includes any writing, or recorded material supplied on or with the kit, or which otherwise accompanies the kit.
  • one or both of the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and the anti-Trop-2 ADC (e.g., sacituzumab govitecan) are provided in a dosage form (e.g., a therapeutically effective dosage form).
  • a dosage form e.g., a therapeutically effective dosage form.
  • one or both of the agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and the anti-Trop-2 ADC (e.g., sacituzumab govitecan) are provided in two or more different dosage forms (e.g., two or more different therapeutically effective dosage forms).
  • one or both of the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • the anti-Trop-2 ADC e.g., sacituzumab govitecan
  • any convenient packaging e.g., stick pack, dose pack, etc.
  • the agent that inhibits binding between CD47 and SIRPa e.g., magrolimab
  • an anti-Trop-2 ADC e.g. , sacituzumab govitecan
  • the agent that inhibits binding between CD47 and SIRPa and the anti-Trop-2 ADC are provided in separate containers.
  • compositions comprising one or both of an agent that inhibits binding between CD47 and SIRPa (e.g., magrolimab) and an anti-Trop-2 ADC (e.g., sacituzumab govitecan) are provided in one or more containers, the containers having a label.
  • Suitable containers include, for example, bottles, vials, ampoules, syringes (including pre-loaded syringes), and test tubes.
  • the containers may be formed from a variety of materials such as glass or plastic.
  • the container holds a composition which is effective for treating the condition and may have a sterile access port (for example the container may be an intravenous solution bag or a vial having a stopper pierceable by a hypodermic injection needle).
  • the active agent in one composition is the agent that inhibits binding between CD47 and SIRPa (e.g., the anti-CD47 antibody, e.g., magrolimab).
  • the active agent in a second composition is an anti-Trop-2 ADC (e.g., sacituzumab govitecan).
  • the label on, or associated with, the container indicates that the composition is used for treating the condition of choice.
  • the article of manufacture may further comprise one or more containers comprising a pharmaceutically- acceptable buffer, e.g., for use as diluent.
  • Illustrative buffers include without limitation phosphate -buffered saline, Ringer’s solution and/or dextrose solution.
  • kits may further include other materials desirable from a commercial and user standpoint, including other buffers, diluents, filters, needles, syringes, and package inserts with instructions for use.
  • the subject kits include a primer agent (e.g., an erythropoiesis-stimulating agent (ESA)) and an anti-CD47 agent.
  • a kit comprises two or more primer agents.
  • a kit comprises two or more anti- CD47 agents.
  • a primer agent is provided in a dosage form (e.g., a priming dosage form).
  • a primer agent is provided in two or more different dosage forms (e.g., two or more different priming dosage forms).
  • the subject kits may further include (in certain embodiments) instructions for practicing the subject methods.
  • These instructions may be present in the subject kits in a variety of forms, one or more of which may be present in the kit.
  • One form in which these instructions may be present is as printed information on a suitable medium or substrate, e.g., a piece or pieces of paper on which the information is printed, in the packaging of the kit, in a package insert, and the like.
  • Yet another form of these instructions is a computer readable medium, e.g., diskette, compact disk (CD), flash drive, and the like, on which the information has been recorded.
  • Yet another form of these instructions that may be present is a website address which may be used via the internet to access the information at a removed site.
  • Table 1 presents the study objectives and end points.
  • TNBC Triple-Negative Breast Cancer
  • Safety Run magrolimab in combination with sacituzumab govitecan in patients with unresectable, locally advanced or mTNBC who have received 1 prior line of treatment in the unresectable, locally advanced or metastatic setting.
  • DLT Dose-Limiting Toxicity Assessment Period for Safety Run: The DLT assessment period will be the first cycle (21 days). Patients are considered evaluable for assessment of a DLT if either of the following criteria is met in the DLT assessment period: • The patient experienced a DLT at any time after initiation of the first infusion of magrolimab.
  • Phase 2 Once Safety Run is completed and the recommended Phase 2 dose for magrolimab in combination with sacituzumab govitecan is determined, the sponsor will open Phase 2.
  • magrolimab in combination with sacituzumab govitecan is administered to patients with unresectable, locally advanced or mTNBC who have received one prior line of treatment in the unresectable, locally advanced or metastatic setting.
  • the primary efficacy assessment will be investigator assessed confirmed objective response rate (ORR).
  • Cycle lengths are 21 days. All patients will continue study treatment unless they meet study treatment discontinuation criteria.
  • Pretreatment blood cross -match completed Male and female patients of childbearing potential who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception 0) Measurable disease according to RECIST, Version 1.1.
  • Previously irradiated lesions can be considered as measurable disease only if disease progression has been unequivocally documented at that site since radiation. 1) Patients must have a life expectancy of 3 months or greater, in the opinion of the investigator.
  • CNS Active central nervous system
  • RBC transfusion dependence defined as requiring more than 2 units of packed RBC transfusions during the 4-week period prior to screening. RBC transfusions are permitted during the screening period and prior to enrollment to meet the hemoglobin inclusion criteria
  • Second malignancy except treated basal cell or localized squamous skin carcinomas, localized prostate cancer, or other malignancies for which patients are not on active anticancer therapies and who are in complete remission for over 2 years 12) Known active or chronic hepatitis B or C infection or human immunodeficiency virus infection in medical history
  • Table 2 shows the study treatments for Safety Run and Table 3 shows the study treatments for Phase 2. Sacituzumab govitecan use will be in accordance with local standard practices or current local prescribing information.
  • Cycle 1 Day 1 treatment can be administered over 2 days such that magrolimab is administered on Cycle 1 Day 1 and sacituzumab govitecan on Cycle 1 Day 2. This also applies to repriming cycles that require Cycle 1 Day 1 dosing of magrolimab.
  • IV intravenous
  • RP2D recommended Phase 2 dose a RP2D as determined in the Safety Run-in Cohort.
  • Treatment was initiated post-randomization using sacituzumab govitecan as a single agent or in combination with magrolimab, as outlined in Table 4.
  • Anti-tumor activity derived from FcyR binding and the SN- 38 pay load were controlled by treating cohorts with h!gG4, an isotype control for magrolimab, and SN-38-hIgGl (ADC Iso), the SN-38-conjugated isotype control for sacituzumab govitecan.
  • Tumor volume was monitored alongside body weight twice a week as readouts for therapeutic efficacy and tolerability with a study endpoint of 1500 mm 3 or 100 days ( Figure 2).
  • the median duration of survival for mice treated with hIgG4 and hlgGl or SN38- hlgGl were 67 and 64 days, respectively.
  • Sacituzumab govitecan when administered at a sub- optimal dose of 100 pg extended the median survival to 85 days, eliciting a tumor growth inhibition (TGI) rate of 45%.
  • TGI tumor growth inhibition
  • magrolimab was very effective at inhibiting tumor growth as a single-agent (98% TGI at day 67), complete tumor regression was not observed at the study endpoint and tumors regrew upon withdrawal of treatment.

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Abstract

L'invention concerne des méthodes de traitement, d'atténuation ou de prévention ou de retardement de la croissance, de la prolifération, de la récurrence ou de la métastase d'un cancer exprimant Trop -2 chez un sujet par administration d'une quantité efficace de : (a) un agent qui Inhibe la liaison entre CD47 et SIRPα (par exemple, le magrolimab) ; et (b) un conjugué anticorps-médicament anti-Trop-2 (ADC) (par exemple, le sacituzumab govitécan) au sujet.
EP23717004.8A 2022-03-24 2023-03-21 Polythérapie pour le traitement de cancers exprimant trop -2 Withdrawn EP4499146A1 (fr)

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